目的: 分析紧张-应对互动模式下的多模态运动训练对脑梗死（cerebral infarction,CI）后偏瘫患者神经功能、健康行为的影响。方法: 纳入2023年9月—2024年9月本院收治的CI后偏瘫患者113例,通过随机数字表法分为观察组（n=56）、对照组（n=57）。对照组接受常规护理,观察组则在常规护理的基础上接受紧张-应对互动模式下的多模态运动训练,两组均连续进行干预4周。比较两组神经功能、心理状态 、肢体功能、生活自理能力、自我效能、健康行为（干预前、干预4周后）,满意度（干预4周后）。结果: 较干预前,干预4周后两组美国国立卫生研究院卒中量表（national institutes of health stroke scale,NIHSS）、汉密尔顿抑郁评定量表（hamilton depression rating scale,HAMD）、汉密尔顿焦虑评定量表（hamilton anxiety rating scale,HAMA）评分均降低,且干预4周后观察组的NIHSS、HAMD、HAMA评分均低于对照组。较干预前,干预4周后两组Fugl-Meyer（FMA）、生活自理能力评分均升高,且观察组均高于对照组。较干预前,干预4周后两组自我效能各项评分均升高,且观察组的情绪控制、管理健康问题、自我保健、合理休息、疼痛及不适控制和遵医用药均高于对照组。较干预前,干预4周后两组健康行为各项评分均升高,且观察组的营养、运动锻炼、人际间关系、压力管理、健康责任感、自我实现评分更高于对照组。干预4周后,相较对照组的总满意度（75.44%）,观察组的更高（96.43%）。结论: CI后偏瘫,应用紧张-应对互动模式下的多模态运动训练能够提高患者的健康行为、生活自理能力及自我效能感,促进其肢体功能、神经功能的恢复,改善患者焦虑抑郁的不良心理状态,同时患者对干预的满意度更高。
Abstract
Objective To analyze the effects of multimodal exercise training under the stress-coping interaction mode on neurological function and health behavior of hemiplegic patients after cerebral infarction (CI). Methods 113 patients with hemiplegia after CI admitted to our hospital from September 2023 to September 2024 were divided into observation group (n=56) and control group (n=57) by random number table method. The control group received routine nursing, while the observation group received multimodal exercise training under the tension-coping interaction mode on the basis of routine nursing. Both groups were intervened continuously for 4 weeks. The neurological function, mental state, limb function, self-care ability, self-efficacy and healthy behavior (before intervention and after 4 weeks of intervention) and satisfaction (after 4 weeks of intervention) were compared between the two groups. Results Compared with before the intervention, the scores of the National Institutes of Health Stroke Scale (NIHSS), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Rating Scale (HAMA) in both groups decreased after 4 weeks of intervention. The NIHSS, HAMD, and HAMA scores of the observation group after 4 weeks of intervention lower than those of the control group. Compared with before intervention, the Fugl Meyer (FMA), life self-care ability scores of both groups increased after 4 weeks of intervention, the scores of observation group after 4 weeks of intervention were higher than those of control group. Compared with before the intervention, the self-efficacy scores of both groups increased after 4 weeks of intervention. Among them, the emotional control, health problem management, self-care, reasonable rest, pain and discomfort control, and medication adherence of observation group after 4 weeks of intervention higher than those of control group's points. Compared with before intervention, the scores of health behavior in both groups increased after 4 weeks of intervention. The nutrition, exercise, interpersonal relationships, stress management, health responsibility, and self actualization in the observation group after 4 weeks were higher than those in the control group. After 4 weeks of intervention, the total satisfaction rate of the observation group (96.43%) was higher than that of the control group (75.44%). Conclusion For hemiplegia after CI, the application of multimodal exercise training in stress-coping interaction mode can improve patients' health behavior, self-care ability and self-efficacy, promote the recovery of their limb function and neurological function, improve their bad psychological state of anxiety and depression, and at the same time, patients are more satisfied with the intervention.
关键词
脑梗死 /
偏瘫 /
紧张-应对互动模式 /
多模态运动训练 /
神经功能 /
健康行为
Key words
cerebral infarction /
hemiplegia /
tension-coping interaction mode /
multimodal exercise training /
neurological function /
healthy behavior
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基金
中国民族医药学会科研项目（2021Z1066-410113）;安徽中医药大学2019—2020年度新安医学教育部重点实验室开放基金项目（2020xayx09）
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