摘要
目的构建适合糖尿病足溃疡(DFU)患者的非负重运动项目,并评价其可行性。方法基于启发式框架,于2021年9—10月在中南大学湘雅医院招募109例DFU患者作为研究对象,采用横断面调查、质性访谈、汉化方案和专家会议的方法形成基于自我决定理论的非负重运动项目;并于同年11—12月招募15例DFU患者开展类实验研究评价其安全性和可行性。收集研究对象进行非负重运动干预前后糖化血红蛋白(HbA1c)、踝肱指数(ABI)、下肢肌力和溃疡面积。采用配对样本t检验对干预前后指标进行比较。结果DFU患者运动行为不佳,其运动障碍包含心理、生理和环境障碍3个主题。通过专家会议构建的非负重运动项目围绕DFU患者的运动障碍,开设自我、能力和环境需求主题课程并配备运动视频及手册。类实验研究结果显示,87%(13/15)的DFU患者完成了非负重运动项目(每周至少进行2次运动干预),干预期间无心血管事件(心绞痛发作、猝死)、代谢紊乱(低血糖、高血糖)及骨、关节、韧带损伤等不良事件发生;与干预前相比,干预后DFU患者的ABI和下肢肌力均升高,HbA1c和溃疡面积均下降(P<0.05)。结论构建的非负重运动项目符合中国DFU患者临床情境和运动心理,具有较好的安全性和可行性。
Objective To construct a non-weight-bearing exercise program suitable for patients with diabetic foot ulcer(DFU)in China and to evaluate its feasibility.Methods Based on the heuristic framework,from September to October 2021,109 DFU patients were recruited in Xiangya Hospital of Central South University as the research participants.A cross-sectional survey,qualitative interview,sinicization scheme and expert meeting methods were used to form a non-weight-bearing exercise program based on self-determination theory.From November to December of the same year,15 patients with DFU were recruited to conduct a quasi-experimental study to evaluate its safety and feasibility.Glycated hemoglobin A1c(HbA1c),ankle brachial index(ABI),lower limb muscle strength and ulcer area were collected before and after non-weight-bearing exercise intervention.A paired sample t-test was used to compare the indicators before and after the intervention.Results DFU patients had poor motor behavior,and their movement disorders included psychological,physical and environmental disorders.The non-weight-bearing exercise program focused on movement disorders of DFU patients was constructed through expert meetings.The courses on the topics of self,ability and environmental needs were set up,and exercise videos and manuals were provided.The results of the quasi-experimental study showed that 87%(13/15)of DFU patients completed the non-weight-bearing exercise program(exercise intervention at least twice a week).There were no adverse events such as cardiovascular events(angina attack,sudden death),metabolic disorders(hypoglycemia,hyperglycemia),or bone,joint and ligament injuries during the intervention period.Compared with those before the intervention,ABI and lower limb muscle strength were increased,HbA1c and ulcer area were decreased in DFU patients after intervention(P<0.05).Conclusion The constructed non-weight-bearing exercise program is in line with the clinical situation and exercise psychology of Chinese DFU patients,and has good safety and
作者
姜燕
喻玲
隆晴
罗金桃
周秋红
戴薇薇
何全
李清婷
郭佳
Jiang Yan;Yu Ling;Long Qing;Luo Jintao;Zhou Qiuhong;Dai Weiwei;He Quan;Li Qingting;Guo Jia(Xiangya School of Nursing,Central South University,Changsha 410013,China;Department of Endocrinology,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Nursing,Hunan Traditional Chinese Medicine College,Zhuzhou 412012,China;Department of Human Resources,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Clinical Nursing,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Rehabilitation Medicine,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2023年第2期135-143,共9页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
国家自然科学基金(72264037)
中南大学前沿交叉项目(2023QYJC041)。
关键词
糖尿病足
糖尿病足溃疡
非负重运动
自我决定理论
运动障碍
可行性
Diabetic foot
Diabetic foot ulcer
Non-weight-bearing exercise
Self-determination theory
Movement disorders
Feasibility
