辅助任务导向训练对老年类风湿性关节炎患者手功能康复以及生存质量的影响

目的探讨对老年类风湿性关节炎(RA)应用辅助任务导向训练的干预对其手功能康复以及生存质量的影响。方法选取佛山市第五人民医院治疗的老年RA患者80例,根据入院先后顺序,通过随机数字表分为治疗组40例与对照组40例,入组患者均给予规范抗风湿药物常规治疗,对照组采取常规手部抗阻训练方式,治疗组则在对照组的基础上给予辅助任务导向训练干预,对两组干预1个月,比较干预前后两组患者手指总主动活动度(TAM)、握力、改良Barthel指数评分以及生活质量评价量表(SF-36)评分情况。结果①两组患者治疗前双侧手指TAM、握力、改良Barthel指数评分以及SF-36评分比较差异无统计学意义(P>0.05)。②治疗后,两组双侧手指TAM、握力、改良Barthel指数评分以及SF-36评分分别较组内治疗前明显改善(P<0.05)。治疗后治疗组左手TAM(268.25±20.62)°与右手TAM(259.93±23.44)°分别高于对照组左手TAM(235.56±25.21)°与右手TAM(224.37±21.86)°(P<0.05);治疗后治疗组左手握力(75.12±8.09)mmHg(1 mmHg=0.133 kPa)与右手握力(79.62±7.86)mmHg分别高于对照组左手握力(62.56±7.78)mmHg与右手握力(65.13±8.10)mmHg(P<0.05);治疗后治疗组改良Barthel指数评分(35.25±4.60)分高于对照组改良Barthel指数评分(31.56±5.25)分(P<0.05);治疗后治疗组SF-36评分(88.25±11.62)分高于对照组SF-36评分(80.56±16.21)分(P<0.05)。结论对老年RA进行辅助任务导向训练干预可提高患者手部关节活动度,增强手部握力,提高日常生活手功能活动能力以及改善生存质量水平。

Effects of assisted task-oriented training on hand function rehabilitation and quality of life in elderly patients with rheumatoid arthritis

Objective To investigate the effects of assisted task-oriented training on hand function rehabilitation and quality of life in elderly patients with rheumatoid arthritis(RA).Methods 80 elderly patients with RA treated in Foshan Fifth People's hospital were divided into treatment group(40 cases)and control group(40 cases)according to the order of admission through the random number table method.All patients in the groups were given standard anti rheumatic drugs for routine treatment,the control group was given routine hand resistance training,and the treatment group was given assisted task-oriented training intervention on the basis of the control group,After one month of intervention,the total active movement(TAM)of fingers,grip strength,modified Barthel index score and quality of life evaluation scale(SF-36)were compared between the two groups before and after intervention.Results①Before treatment,there were no significant differences in bilateral finger TAM,grip strength,modified Barthel index score and SF-36 score between 2 group(P>0.05).②After treatment,bilateral finger TAM,grip strength,modified Barthel index score and SF-36 score were significantly improved in both groups compared with before treatment(P<0.05).After treatment,the left TAM(268.25±20.62)°and the right TAM(259.93±23.44)°in the treatment group were higher than those in the control group of left TAM(235.56±25.21)°and right TAM(224.37±21.86)°(P<0.05);After treatment,the left hand grip strength of(75.12±8.09)mmHg(1mmHg=0.133kPa)and the right hand grip strength(79.62±7.86)mmHg in the treatment group were higher than the left hand grip strength of(62.56±7.78)mmHg and the right hand grip strength(65.13±8.10)mmHg,respectively in the control group(P<0.05).After treatment,the improved Barthel index score of the treatment group(35.25±4.60)was higher than(31.56±5.25)of the control group(P<0.05).After treatment,the SF-36 score of the treatment group(88.25±11.62)was higher than(80.56±16.21)of the control group(P<0.05).Conclusion Assisted task-oriented training intervention for elderly patients with rheumatoid arthritis can improve the range of motion of hand joints,enhance hand grip strength,improve hand function and activity in daily life and improve the quality of life.