摘要
目的评价作业疗法和道家认知疗法对脑卒中偏瘫恢复期患者情绪障碍的康复效果。方法将136例脑卒中偏瘫恢复期伴情绪障碍患者随机分为一般治疗组(一般组)、认知治疗组(认知组)、作业治疗组(作业组)及综合治疗组(综合组),标准治疗期8周,跟踪随访半年。治疗前、治疗结束时及随访期末,采用Fugl-Meyer评定法的上肢主动运动功能积分、加拿大作业活动量表(COPM)、症状自评量表(SCL-90)分别对患者偏瘫上肢运动功能、日常生活活动能力及焦虑、抑郁等负性情绪进行评定,并进行统计分析。结果所有患者Fugl-Meyer、COPM评分逐渐升高,升高幅度由高到低依次为综合组、作业组、认知组、一般组,组间比较,差异有统计学意义(P<0.01);作业组SCL-90的3次评分依次为(100.36±26.41)分、(53.89±12.45)分及(63.65±16.23)分,与一般组的(98.22±25.38)分、(62.72±13.90)分及(80.36±21.79)分呈相同变化趋势,但治疗后及随访期末评分均低于一般组(P<0.01);认知组治疗结束时的SCL-90评分为(58.63±12.27)分,略高于作业组(P<0.01),随访期末为(44.72±10.54)分,明显低于作业组(P<0.01);综合组治疗结束时及随访期末SCL-90评分分别为(49.15±11.84)和(39.26±10.47)分,低于认知组及作业组(P<0.01)。结论作业疗法或道家认知疗法能不同程度地减轻脑卒中偏瘫恢复期患者的情绪障碍,改善其偏瘫上肢的运动功能及日常生活活动能力;二者结合,可以取长补短,有利于患者身心的全面康复。
Objective To evaluate the effects of occupational therapy and Taoist cognitive psychotherapy on emotional disorder of stroke patients. Methods A total of 136 hemiplegic patients with emotional disorder were randomly divided into a general treatment group, a cognitive psychotherapy group, an occupational therapy group and a combined therapy group （occupational therapy combined Taoist cognitive psychotherapy group）. All patients were treated accordingly for 8 weeks and followed up for 6 months. All the patients were evaluated with Fugl-Meyer Assessment, COPM and SCL-90. Results It was found that the Fugl-Meyer Assessment and COPM scores were improved gradually in all groups. The combined therapy group scored higher than occupational therapy group （P 〈0.01 ） , the occupational therapy group scored significantly higher than general treatment group and cognitive psychotherapy group （P〈0.01）.The SCL-90 scores （100.36 ±26.41, 53.89 ±12.45, 63.65 ± 16.23） in the occupational therapy group were lower than general treatment group （98.22 ± 25.38,62.72 ± 13.90,80.36 ± 21.79 ; P 〈 0.01 ）. The SCL-90 scores （99.18 ±24.56, 58.63 ±12.27, 44.72 ± 10.54） in cognitive psychotherapy group were significantly lower than occupational therapy group in the end of the follow-up period （ P 〈 0.01 ）. The SCL-90 scores （ 100.42± 25.44, 49.15 ± 11.84, 39.26 ± 10.47 ） in combined therapy group were lower than those in cognitive psychotherapy group and occupational therapy group （P 〈 0.01）. Conclusion The occupational therapy or Taoist cognitive psychotherapy can help improve emotional disorder in patients with hemiplegia, and improve their motor function of upper limbs and activities of daily living performance. Occupational therapy in conjunct with Taoist cognitive psychotherapy may significantly help improve stroke patients both physically and mentally.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2007年第9期627-630,共4页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
作业疗法
情绪障碍
偏瘫
道家认知疗法
Occupational therapy
Emotional disorder
Hemiplegia
Taoist cognitive psychotherapy
