目的 分析阶段性功能锻炼与抗阻运动对老年肌少症患者躯体功能和日常生活能力(ADL)影响的对比.方法 选择140例老年肌少症患者,依据随机数字表法均分为两组;阶段性功能组70例给予阶段性功能锻炼干预,抗阻训练组70例给予抗阻训练方案;比较两组干预前后ADL、简短肌肉功能测试评分(SPPB)、单腿站立测试(OLS)、功能性步态测试(FGA)、Berg平衡量表(BBS)、握力、四肢骨骼肌质量指数(RASM)及6 min步行实验距离(6MWT)、血清C反应蛋白(CRP)、白细胞介素(IL)-1β、IL-2及并发症发生率.结果 干预后,两组ADL评分、SPPB评分、OLS、FGA、BBS、握力、RASM、6MWT明显升高(P<0.05),且抗阻训练组均显著高于阶段性功能组(P<0.05);两组CRP、IL-1β、IL-2水平明显下降,且抗阻训练组显著低于阶段性功能组(P<0.05);两组并发症发生率差异无统计学意义(P>0.05).结论 抗阻运动可以有效提高患者躯体功能及日常自理能力,改善患者肌肉力量,抑制机体炎症因子,临床疗效较好,预后肯定.

失语症(aphasia)是指由于脑部器质性损伤[1],导致原已习得的语言功能损伤[2],而出现的获得性语言障碍,表现为听、说、读、写或手势等某一方面或几方面的多感觉通道的语言障碍[3].命名障碍(anomia)也称找词困难或回忆障碍,不能随意提取已熟知的词,对已熟记的物品或事物再次感知时不能正确说其名称,但是了解该物品或事物的用途或含义[4].几乎所有失语症患者均存在不同程度的命名障碍[5-6],并伴随病程的始终[7].

Objective:To compare the efficacy of series casting with different timings after botulinum toxin injection among equinus children with spastic cerebral palsy.Methods:Sixty-three equinus children with spastic cerebral palsy were randomly divided into a control group and an experimental group. After being injected with botulinum toxin type A, 4 weeks of series casting was applied immediately in the control group, while in the experimental group it was applied 2 weeks later. Both groups were given basic rehabilitation therapy including heel walking, kicking balls, single-leg standing, standing platform training and balance training. The modified Tardieu scale, three-dimensional gait analysis, gross motor function measure 88 (GMFM-88) and a self-made questionnaire were used to evaluate muscle tone, spasticity, gait parameters, standing and walking before the treatment and 2 and 6 months afterward.Results:Immediately after the treatment there was a significant improvement in both groups′ average MTS scores (R1, R2, R1-R2 with knee extension and flexion), dorsiflexion at initial contact, peak dorsiflexion in the stance and swing phases, and dimension D (standing), and also in their average GMFM-88 (walking) scores. Two and six months later the experimental group′s average MTS scores, peak dorsiflexion in the stance phase, and dimension D (standing) score in the GMFM-88 (walking) had improved significantly compared with the control group′s averages. However, no significant differences were observed between the two groups in any of the other measurements after the treatment.Conclusion:Delaying series casting after botulinum toxin A injection can significantly reduce tone and spasticity in the plantarflexors, improve the range of motion and functioning of the ankle, and alleviate the discomfort and pain caused by series casting.

小儿脑性瘫痪(cerebral palsy,CP),是指从出生前到出生后一个月内,由各种原因所引起的非进行性脑损伤或发育异常,所导致的中枢性运动功能障碍和姿势异常,为小儿期最主要的运动功能伤残疾病[1].脑瘫的临床表现可分为多个类型,其中痉挛型是最典型和常见的类型.痉挛型患儿由于长期处于高度肌紧张状态,故易发生肌腱短缩、关节挛缩变形,如跟腱短缩形成尖足,患儿行走、站立困难,走路足尖着地,呈剪刀步态,形似马蹄.

Objective:To investigate the therapeutic effects of Kinesio taping combined with physical therapy for plantar fasciitis.Method:A total of 42 patients with plantar fasciitis were randomly and equally divided into two groups.The patients in the control group received only extracorporeal shock wave therapy and manual stretching.The patients in the experimental group received Kinesio taping combined with physical therapy program the same as the control group.For each patient,visual analogue scale (VAS),ultrasonography and AOFAS were applied to evaluate the degree of pain,plantar fascia thickness and foot function before and after treatment.Result:There were no significant differences in general condition,the degree of pain,plantar fascia thickness and AOFAS in two groups before treatment (P ＞ 0.05).After one week treatment,the VAS at the end of a day and AOFAS in experimental group improved more significantly than that in control group (P＜0.05,P＜0.01).After two week treatment,the VAS (in the morning of first step,the end of a day) and AOFAS in experimental group improved more significantly than that in control group (P＜0.01).At the same time,the thickness of plantar fascia reduced significantly in the experimental group than in the control group (P＜0.01).When compared with before treatment,the VAS (in the morning of first step,the end of a day) and AOFAS improved significantly in both group (P＜0.01),except the VAS at the end of a day after one week treatment in control group (P＞0.05).After two weeks treatment,the plantar fascia thickness reduced significantly (P＜0.01) than before treatment in the experimental group.Conclusion:The additional treatment with Kinesio taping for two weeks might alleviate the pain of plantar fasciitis more effectively than physical therapy program only.

国际功能、残疾和健康分类（ Interna?tional Classification of Functioning， Disability and Health，ICF）是世界卫生组织设计的一种可以用于不同学科和领域的多目的性的分类［1］。以ICF理论为指导的作业疗法，强调以患者的喜好和愿望为中心，同时考虑环境和个人因素的影响，强调人在社会中的功能，加强患者的活动水平，提高患者整体生活质量和功能情况，最终目的是使患者回归家庭和社会。

Objective To investigate the significance of the Children's Rehabilitation Management System(ICR 2.0) for occupational therapy(OT) for cerebral palsy(CP).Methods 60 children with CP were divided into group A(n=30) and group B(n=30).The group A accepted OT program assisted with ICR 2.0,and the group B accepted OT program drawn by therapists experientially.They were assessed with Enjoji infant development scale and Fine Motor Function Measure(FMFM) before and 3 months after treatment.Results There was no significant difference in development months and the fine motor between 2 groups before treatment(P0.05).Both the development and fine motor improved after treatment(P0.001),and improved more in the group A than in the group B(P0.05).Conclusion ICR 2.0 assisted OT program can further improve the recovery of children with CP.

Objective: To explore the effects of community-and-family based rehabilitation management on the activities of daily living (ADL) of stroke patients. Method: A total of 276 stroke patients were divided randomly into the community-based rehabilitation management group (treatment group, n=141) and the control group (n=135), The patients of the community -based rehabilitation management group were treated with rehabilitation and following-up, those of the control group were only by following-up. Both groups were evaluated with modified Barthel index before and 2, 5 months after treatment. Result: The ability of ADL in treatment group were more remarkable better than that in control group in the following-up after 5 months treatment (P＜0.01). In treatment group the Barthel index of the patients with a history of 3 to 18 months was significantly higher than that of 3 months (P＜0.01). The data showed that the effect of the disease time has no difference(P＞0.05) after 2, 5 months of treatment, whereas the mark of the treatment group was higher in each stage after 5 months of treatment (P＜0.01). Conclusion: Community-based rehabilitation management has significant effect on the ADL in stroke patients. The regular community-based rehabilitation management also has positive effect on the patients with a history of 3 to 18 months.