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JAMA Neurol:中风患者远程康复治疗的效果研究

2019-07-01 MedSci MedSci原创

研究认为,远程训练有可能大幅度增加获得康复治疗的机会,改善中风患者预后

中风患者接受康复治疗的效果差异十分显著,主要原因是医疗资源有限。近日研究人员考察了通过家庭远程康复(TR)系统提供针对手臂运动的治疗是否与传统的临床治疗(IC)具有相似的效果。

124名在4至36周前经历过卒中且有手臂运动缺陷患者(FuglMeyer[FM]评分),随机在家庭(TR组)接受远程康复治疗或在门诊康复治疗诊所(IC组)接受治疗。参与者接受了36次(分别为70分钟)的手臂运动功能治疗,组间卒中教育,治疗强度、持续时间和频率相似。研究的主要终点为FM评分从基线到治疗结束后4周的变化。

共有124名参与者,平均年龄为61岁,平均基线FM评分为43分。在接受治疗的患者中,IC组患者平均完成了33.6个疗程(93.3%),TR组患者平均完成了35.4个疗程(98.3%)。IC组治疗前至治疗后30d的平均FM评分变化为8.36,TR组为7.86。经协变量调整后,TR组FM评分变化为0.06,提示TR不低于IC治疗。在脑卒中后早期(<90天)或晚(≥90天)分别检测患者运动功能的增加仍有显著性意义。

研究认为,远程训练有可能大幅度增加获得康复治疗的机会,改善中风患者预后。

原始出处:


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    2019-10-22 yinhl1978
  2. [GetPortalCommentsPageByObjectIdResponse(id=2000802, encodeId=794a200080225, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Oct 22 04:25:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=375421, encodeId=8dc03e542104, content=中风患者的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sat Nov 16 19:45:14 CST 2019, time=2019-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=368927, encodeId=259736892ef7, content=中风患者的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Jul 03 20:03:22 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538079, encodeId=b89415380e9a9, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Wed Jul 03 12:25:00 CST 2019, time=2019-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045875, encodeId=de6810458e515, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Jul 02 00:25:00 CST 2019, time=2019-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046860, encodeId=71c71046860f0, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Tue Jul 02 00:25:00 CST 2019, time=2019-07-02, status=1, ipAttribution=)]
    2019-11-16 jyzxjiangqin

    中风患者的治疗。

    0

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    2019-07-03 jyzxjiangqin

    中风患者的治疗。

    0

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    2019-07-02 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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    2019-07-02 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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JAMA Neurology:是疲劳还是中风?加拿大研究称,女士小中风更易被误诊

发现,尽管男性和女性同样可能报告非典型的卒中症状,男性更容易被诊断为短暂性脑缺血发作或小卒中,而女性更容易被诊断偏头痛或眩晕。

Cell :中风治疗新篇章-抑制细胞铁死亡

研究发现神经元通过诱导硒蛋白(包括谷胱甘肽过氧化物酶4(GPX4))对铁死亡相关刺激做出反应。硒(Se)可在铁死亡过程中增强GPX4和其它基因的转录,通过共激活转录因子TFAP2c和Sp1来保护神经元,在中风的营养和治疗中有重要意义。

Circulation:需口服抗凝的房颤负荷阈值和中风风险

房颤(AF)与中风风险增加有关;但尚无明确的开始口服抗凝(OAC)的AF负荷阈值。现研究人员尝试研究OAC处方实践的变化与新发房颤预后的关系。研究人员开展一回顾性队列研究,纳入心脏植入电子设备、与2011年-2014年进行远程监测、CHA2DS20VASc评分≥2,而且无中风史的患者或在过去2年口服抗凝的患者。在10212位心脏植入电子设备的患者中,其中4570(45%)、3969(39%)、32

BMJ:替卡格雷对轻度中风或短暂性缺血血小板反应性的影响

研究认为,与使用氯吡格雷加阿司匹林治疗的患者相比,使用替卡格雷加阿司匹林治疗的轻度中风或短暂性缺血发作患者血小板反应性高的比例较低,尤其是携带CYP2C19功能丧失等位基因的患者

Lancet:全新中国疾病负担报告——中国疾病谱发生重大变化,中风、缺血性心脏病和慢阻肺是国人三大杀手

6月24日,Lancet杂志在线发表了由中国疾病预防控制中心梁晓峰等与美国华盛顿大学合作完成的最新中国疾病负担结果。

为何日本中风患者过半康复而中国80%术后不能自理

急性康复的最大障碍不是医疗水平,而在于医疗价值观——不仅要活着,还要活得像从前一样。在日本,65岁以上的中风患者群体中,有一半以上的概率恢复行走,接近一半的概率恢复日常生活;在小于65岁的患者群体中,行走和恢复以往生活的人数均大于60%。在中国的中风患者中,70%-80%的人将因为中风后遗症偏瘫、语言和吞咽功能的丧失而失去自理能力。按这个比例,在中国每年250万的新发中风病例中,患病后生活不能

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