摘要
脑卒中属高致残率疾病,患者遗留的上肢功能障碍会严重影响其日常生活活动能力及其质量。任务导向性训练(task-oriented training,TOT)是脑卒中后上肢功能康复的前沿治疗技术,它以运动控制和运动学习为基础,将任务融入特定情境中,梯度式调整训练难度,通过反馈和重复激发患者的内部动机,从而产生内驱力,加速患者肢体功能恢复。在脑卒中早期,TOT可用于上肢功能轻中度损伤患者,预防废用性上肢功能衰退;在脑卒中恢复期,TOT基于任务导向的作业活动训练可促进患者脑功能重组,加速患者上肢功能恢复;在脑卒中后遗症期,TOT可强化患者上肢相关的作业活动和作业技能表现,提高患者的生活自理能力和社会参与度,帮助患者回归家庭和社会。梯度式TOT与三级康复模式相匹配,能最大限度地减轻患者残疾。本文围绕TOT在脑卒中恢复不同阶段的康复应用,对国内外近年来的研究进展作一概要介绍。
Stroke is a disease with high disability rate,and the residual upper limb dysfunction significantly affects the patient’s ability and quality of daily life.Task-oriented training(TOT)is a cutting-edge treatment technology for upper limb functional rehabilitation in stroke.It is based on motor control and motor learning,integrating tasks into specific environments,adjusting training difficulty in a stepped manner,stimulating the patient’s self-efficacy through feedback and repetition,and accelerating the patient’s limb functional recovery.In the early stages of stroke,TOT can be used for patients with mild to moderate upper limb function impairments to prevent disuse-related functional decline;during the recovery period of stroke,based on task-oriented activity training,TOT can promote the reorganization of brain function in patients and accelerate the recovery of upper limb function;during the sequelae of stroke,TOT can enhance the daily activities related to the upper limbs of patients,improve their functional independence,and help them return to their families and society.The stepped TOT training is matched with a three-level rehabilitation mode,which can minimize the disability in patients.This article focuses on the application of TOT in the different stages of stroke recovery and summarizes the research progress at home and abroad in recent years.
作者
项育枝
陈逸浩
毕照东
刘兰兰
王鹤玮
XIANG Yuzhi;CHEN Yihao;BI Zhaodong;LIU Lanlan;WANG Hewei(Department of Intensive Care Rehabilitation,Shanghai Third Rehabilitation Hospital,Shanghai 200436,China;Department of Rehabilitation Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《上海医药》
CAS
2024年第3期3-8,15,共7页
Shanghai Medical & Pharmaceutical Journal
基金
国家自然科学基金青年科学基金项目(82102665)
上海市科学技术委员会“扬帆计划”项目(21Y1404600、21YF1404600)
上海市静安区卫生科研课题面上项目(2021MS17)
上海市静安区卫生系统重点学科建设项目(2021PY04)。
关键词
任务导向性训练
脑卒中
上肢功能
task-oriented training
stroke
upper extremity function
