目的:汉化上肢活动量表(arm activity measure,ArmA)并分析其信度和效度,为评估脑卒中患者痉挛后上肢功能障碍提供简单、有效的工具.方法:对英文版ArmA进行翻译和文化调试,并使用中文版ArmA对50例脑卒中患者进行自我评估,对其结果进行重测信度、内在一致性和效度分析.结果:试验共入组50例脑卒中患者,平均年龄(52.32±14.83)岁.中文版ArmA量表被动部分与主动部分Cronbachα系数分别为0.718和0.831;重测信度的总分组内相关系数ICC为0.990,各条目的ICC值范围为0.902-1.000;每个条目与其所在维度的相关系数均在0.4以上(P＜0.05),且均高于与其他维度的相关系数;结构效度主成分分析的结果共提取4个公因子;通过spearman相关分析发现,中文版ArmA量表主动部分与上肢Fugl-Meyer量表具有一定相关,与改良Ashworth量表(modified Ashworth scale,MAS)相关性无显著性差异(P＞0.05).结论:中文版ArmA量表在脑卒中患者中具有良好的信度和效度,且评测可操作性高,适用于评估我国脑卒中患者痉挛后上肢的活动功能.

目的:分析脑卒中对患者呼吸功能的影响,探讨呼吸功能与运动功能的相关性.方法:选取2020年9月至2021年5月中山大学孙逸仙纪念医院康复医学科收治的15例脑卒中患者为观察组和15例同龄健康人为对照组.两组分别进行呼吸功能和运动功能的测定.呼吸功能评定包括:肺通气测试、吸气肌肌力测试(MIP)和呼气肌肌力测试(MEP);运动功能评定包括:Fugl-Meyer评分法(FMA)、Berg平衡量表(Berg)、生理耗损指数(PCI)、6min步行试验(6MWT)、10m步行试验(10MWT)和握力评估.采用Pearson相关性和Spearman相关性分析方法研究脑卒中患者呼吸功能的变化,以及分析脑卒中患者呼吸功能与运动功能的相关性.结果:与对照组相比,观察组的呼吸功能指标:25％用力呼气量(FEF25)、50％用力呼气量(FEF50)、最大呼气中期流量(MMEF)、用力吸气量(FIVC)、峰值呼气流速(PEF)、第一秒用力呼气量(FEV1)、MIP、MEP均降低,差异存在显著性意义(P＜0.05).卒中患者的FVC和FIVC与握力均呈中度正相关(r=0.608,r=0.528,P＜0.05);FEF50、FEV1、FIVC、FEV1/FVC 和 MEP 与 Berg 呈正相关(r=0.564,r=0.607,r=0.535,r=0.566,r=0.566,P＜0.05);MEP 和 FEV1 与 6min 步行距离呈中度正相关(r=0.536,r=0.522,P＜0.05),对照组其他肺功能指标与运动功能无显著相关性(P＞0.05).结论:脑卒中患者的呼吸功能较正常人明显下降,且脑卒中患者运动功能和呼吸功能的下降存在相关性.

ObjectiveFocusing on the intelligent and multi-channel functional electrical stimulation (FES) based on normal walking patterns, we explored the correlation between therapeutic effect and stimulating time for improving lower extremity motor function of stroke patients, to provide evidence for further clinical applications of FES based on walking patterns.MethodsThe Minimize software was used to divided 18 stroke patients randomly into a group treated with 60 min FES in walking pattern (9 patients, 60 min-stimulation group), and the rest were treated with 30 min FES in walking pattern (9 patients, 30 min-stimulation group). Both groups received conventional rehabilitation treatment. In addition, the 60 min-stimulation group received FES in walking pattern for 30 min and electric stimulation in the decumbent position for 30 min, while 30 min-stimulation group received FES in walking pattern for 30 min and placebo stimulation for 30 min. The electrical stimulation treatment was applied once per day, 5 days per week and totally 15 times. Participants' lower extremity motor functions and ability in daily activities were assessed via modified Ashworth scale (MAS), manual muscle test (MMT), Fugl-Meyer assessment-lower extremity (FMA-LE), Berg balance scale (BBS), 10 meter walk test (10MWT) and modified Barthel index (MBI) in 4 time points: before treatment, after treatments for 7 times, after treatments for 15 times and one month follow up.ResultsCompared with before treatment, MAS, MMT, FMA-LE and BBS were statistically different in two groups after treatments for 7 times, 15 times and one month follow up (P<0.05). In the 60 min-stimulation group, statistically significant differences in MBI assessments appeared in 3 time points after treatment (P<0.05), while the 30 min-stimulation group only had statistical differences after treatments for 7 times and 15 times (P<0.05). Besides, the 60 min-stimulation group had statistically significant differences in walking speed after treatments for 7 times and 15 times, while the 30 min-stimulation group only had a statistically significant difference after treatments for 15 times (P<0.05). Comparing between the two groups, the 60 min-stimulation group showed more significantly improvements in MAS and walking speed after treatments for 7 times (P<0.05); After treatments for 15 times, differences were found in MAS, FMA-LE and MBI (P<0.05) and there were still statistical differences between MAS and MBI during the following-up (P<0.05).ConclusionThe intelligent, multi-channel functional electrical stimulation can effectively improve the lower extremity motor function, balance, walking and daily life activities of stroke patients. While prolonged stimulation time (from 30 min-stimulation to 60 min-stimulation) not only can enhance the therapeutic effect of reducing muscle tone, improving motor function of the affected lower limb, improving gait speed and self-care ability, but also can prolong the duration of the efficacy of self-care ability.

目的:翻译挪威版改良躯干损伤量表(the Trunk Impairment Scale-modified to Norwegian Version,mTIS),并探讨其在脑卒中患者应用中的信度与效度,为其临床应用提供客观依据.方法:将挪威版mTIS翻译为中文版mTIS.共入组30例病例,在入组第一天,评定者A与B同时但独立对患者进行中文版mTIS量表评估,评定者A再对患者进行Fugl-Meyer量表的下肢运动部分(The Fugl-Meyer Assessment of Lower Extremity,FMA-LE)、改良 Barthel 指数(Modified Barthel Index,MBI)、Berg 平衡量表(Berg Balance Scale,BBS)和脑卒中患者姿势评定量表(Postural Assessment Scale for Stroke Patient,PASS)评估.在入组第二天,评定者A再进行一次中文版mTIS评估.采用组内相关系数法(Intra-class Correlation Coefficient,ICC))分析评定者内部的重测信度和评定者间信度,采用Pearson相关系数法检测效度.结果:在信度研究中,评定者A与B之间的中文版mTIS总分、动态坐位平衡分量表得分、协调分量表得分的ICC分别为0.978,0.967,0.902,评定者A两次评定结果之间的中文版mTIS总分、动态坐位平衡分量表得分、协调分量表得分的ICC分别为0.971,0.969,0.901.在效度研究中,中文版mTIS得分与FMA-LE得分的相关系数r=0.806,P＜0.05;与MBI得分的相关系数r=0.802,P＜0.05;与BBS得分的相关系数r=0.734,P＜0.05;与PASS得分的相关系数r=0.775,P＜0.05.结论:中文版改良躯干损伤量表在脑卒中患者应用中具有良好的重测信度、评定者间信度和较好的效度.

目的:汉化吞咽障碍造影评分量表(videofluoroscopic dysphagia scale,VDS)并分析其信度和效度,为评估脑卒中患者吞咽障碍提供简单、有效的工具.方法:对英文版VDS进行翻译和文化调适,并采用中文版VDS对47例脑卒中患者进行评估,对其结果进行信度和效度分析.结果:中文版VDS量表总体Cronbach's α系数为0.769,各维度的Cronbach's α系数是0.707-0.912;重测信度总体的组内相关系数(intraclass correlation coefficient,ICC)为0.951,各条目的ICC为0.732-1.000;测量者间信度总体的ICC为0.731,各条目的ICC为0.703-0.877;每一个条目与其所在维度的相关系数为0.721-0.854(P＜0.01),每一个条目与其所在维度的相关系数均高于其他维度的相关系数;结构效度采用因子分析,共提取出4个公因子,累积贡献率为64.59％;通过spearman相关分析其外部效度发现中文版VDS量表结果与中文版经口摄食功能评估量表结果、健康调查简表结果相关.结论:中文版VDS量表在脑卒中患者检验中具有好的信度与效度,可用于评估我国脑卒中后吞咽障碍患者的吞咽功能.

近5年来,开设康复治疗专业的院校数及招生人数增长迅速[1-2].作为一个新兴的学科,康复治疗专业毕业生的就业状况如何?他们是否满意自己所接受的教育和工作?影响他们教学满意度和工作满意度的影响因素有哪些?社会应该采取哪些措施增强康复治疗队伍的稳定性?这些都是值得关注的问题.因此有必要尽快研制康复治疗专业专用的就业满意度和教学满意度调查表,为提高康复治疗从业人员的工作状况奠定基础.本文编制适合中国康复治疗专业毕业生的满意度问卷调查表,并综合评价该调查表的性能,为此调查表的应用提供可靠依据.见附表.

近年来,随着社会进步、人口老龄化进程加快、自然灾害意外伤害增多,残疾人事业迅速发展,社会对康复治疗技术人才的需求不断增加;康复治疗学专业得到越来越多的关注和重视,全国各地高等院校纷纷开设该专业[1-4],以满足各级医疗卫生机构对康复治疗师的需求.