吴彩虹 时美芳 傅建明 吴华 李岩 李亮 陶林花 李小龙 李辉

[摘要] 目的 探討基于躯体传感系统的远程日常生活活动能力康复训练对脑卒中偏瘫出院患者生活质量的影响。 方法 选取2017年7月～2020年3月我院康复医学中心脑卒中偏瘫的出院患者40例，随机分为干预组19例和对照组21例。对照组予出院用药及日常生活活动能力康复训练指导，每月门诊复诊强化。干预组在出院用药的同时采用躯体传感系统进行远程日常生活活动能力康复训练及指导，两组训练均为每次10～20 min，每周6次，共12周。训练前及训练12周后采用Fugl-Meyer评分（FMA）、改良Barthel指数（MBI）、脑卒中专用生活质量量表（SS-QOL）对两组运动功能、日常生活活动能力、生活质量进行评定。 结果 训练前两组FMA评分、MBI评分及SS-QOL各项评分比较，差异无统计学意义（P>0.05），训练12周后，两组FMA评分、MBI评分、SS-QOL各项评分，组内比较均明显改善，差异有统计学意义（P<0.05）。其中FMA评分、MBI评分比较，干预组优于对照组（P<0.05）。SS-QOL评分中精力、家庭角色、语言、活动、情绪、个性、自理能力、社会角色、思维、上肢功能、工作/劳动比较，干预组优于对照组（P<0.05）。干预组与对照组视力比较，差异无统计学意义（P>0.05）。 结论 基于躯体传感系统的远程日常生活活动能力康复训练能进一步改善脑卒中偏瘫出院患者的运动功能及日常生活活动能力，更能提高除视力外的生活质量。

[关键词] 脑卒中;偏瘫;躯体传感系统;远程康复;日常生活活动能力;生活质量

[中图分类号] R49;R743.3          [文献标识码] B          [文章编号] 1673-9701（2020）33-0180-05

[Abstract] Objective To investigate the effect of remote rehabilitation training for activities of daily living based on body sensor system on the quality of life of discharged patients with stroke and hemiplegia. Methods A total of 40 discharged patients with stroke and hemiplegia in the Rehabilitation Medicine Center of our hospital from July 2017 to March 2020 were randomly divided into an intervention group（19 patients） and a control group（21 patients）. The control group was given discharge medication and activities of daily living ability rehabilitation training guidance， and monthly outpatient visits were strengthened. The intervention group used the body sensor system for remote rehabilitation training and guidance of activities of daily living when discharged from the hospital with medication. The training of the two groups was 10-20 minutes each time， six times a week， for a total of 12 weeks. Before training and 12 weeks after training， Fugl-Meyer Score（FMA）， Modified Barthel Index（MBI）， Stroke Special Quality of Life Scale（SS-QOL） were used to evaluate the motor function， activities of daily living， and quality of life of the two groups. Results Before training， there was no significant difference in the FMA score， MBI score， and SS-QOL score between the two groups（P>0.05）. After 12 weeks of training， the FMA score， MBI score， and SS-QOL score of two groups were significantly improved ，and the differences were statistically significant（P<0.05）. Among them， the FMA score and MBI score of the intervention group was better than that of the control group（P<0.05）. The energy， family role， language， activity， emotion， personality， self-care ability， social position， thinking， upper limb function， work/labor in SS-QOL score of the intervention group were better than those of the control group（P<0.05）. There was no significant difference in visual acuity between the intervention group and the control group（P>0.05）. Conclusion The remote rehabilitation training for activities of daily living based on the body sensor system can further improve the motor function and activities of daily living of discharged patients with stroke and hemiplegia. It can also enhance the quality of life except for vision.

[Key words] Stroke; Hemiplegia; Body sensor system; Remote rehabilitation; Activities of daily living; Quality of life

脑卒中发病率、死亡率、复发率、致残率高，在我国呈现年轻化[1-3]。约75%的幸存者后遗运动功能、认知功能、日常生活活动能力（Activitieof daily living，ADL）障碍，严重影响患者的生活质量，增加家庭及社会负担[4]。脑卒中康复需要漫长过程，甚至终身康复。三级康复网络的……