身体康复方法用于在中风后恢复功能和运动能力
Alex Todhunter-Brown1, Ceri E Sellers1, Gillian D Baer2
1Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow, UK.
The Cochrane database of systematic reviews
|February 11, 2025
概括
身体康复可以改善中风后的功能和运动能力. 功能性任务训练可能是最有效的,而神经生理学方法可能不那么有效,尽管证据确定性有限.
科学领域:
- 康复医学 康复医学 康复医学
- 神经学 神经学
- 物理疗法物理治疗
背景情况:
- 脑卒中后的身体康复采用了各种方法,其有效性和最佳交付方法受到争论.
- 治疗师可以使用单一或组合方法,导致治疗策略的异质性.
研究的目的:
- 为了确定身体康复对中风恢复功能和移动性的有效性.
- 为了比较不同身体康复方法的有效性.
- 探索影响康复有效性的因素,如中风后的时间,剂量和干预组件.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库,截至2022年11月,包括Cochrane中风试验注册,CENTRAL,MEDLINE,Embase,AMED,CINAHL和CBM.
- 包括成人中风幸存者的身体康复的RCT;不包括上肢功能或单个治疗组件.
- 使用GRADE方法评估偏差风险和证据确定性.
主要成果:
- 身体康复可能会改善日常生活活动 (IADL) 和运动功能,而不是没有康复 (低确定性证据).
- 功能性任务训练可能会比其他方法 (低确定性证据) 更加强IADL和运动功能.
- 神经生理学方法对IADL可能不那么有效,并且与其他方法相比,运动功能没有显著差异 (低确定性证据).
结论:
- 身体康复,特别是混合组件和功能任务训练,可能有助于中风后的康复.
- 额外的康复可以提供额外的好处.
- 证据的确定性受到研究异质性和报告质量的限制;神经生理学方法似乎不那么有效.
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