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題名:肌肉萎縮性側索硬化症之居家物理治療服務模式之建立與其療效:初步結果     (24點)
The Care Pattern and Effect of Home Physical Therapy in Individuals with Amyotrophic Lateral Sclerosis: A Preliminary Report
著者:林光華(Kwan-Hwa Lin) ;胡名霞(Ming-Hsia Hu) ;簡文仁(Wen-Jen Chien) ;楊智超(Chih-Chao Yang) ;蔡清標(Ching-Piao Tsai) ;鄭悅承(Yueh-Chen Cheng) ;蔡美文(Mei-Wun Tsai)
出版地區:台灣
出版城市:台北市
學科:物理 ; 醫學綜合
關鍵字:肌肉萎縮性側索硬化 ; 功能評估量表 ; 姿勢控制量表 ; 生活品質量表 ; Amyotrophic lateral sclerosis ; Functional assessment ; Postural control ; Quality of life
刊名:物理治療
卷期:29卷6期(2004.12)
頁碼:384-395
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

目的:本研究欲建立罕見疾病肌肉萎縮性側索硬化症(Amyotrophic lateral sclerosis: ALS )居家運動的模式與探討居家物理治療對不同程度的患者的生活功能與生活品質的療效。方法: 本研究選取确定為肌肉萎縮性側索硬化症且居住于是大台北地區(台北縣市與基隆)者, 并依最出病情將其分輕度(步行組)及中重度(輪椅組0二組。實驗采ABA三段方式;第一階段A為觀察期(一個半月), 第二階段B為治療期(一個半月),每周治療一次,共治療6次。治療結束後第三階段A為追蹤期(一個半月)。評估項目為生活功能功能自主量表(ALSFRS)、巴氏量表(Barthel index, BI)、姿勢控制量表(PASS)與生活品持量表(SF-36)等。治療項目采用低阻力彈力帶運動,配合固定式腳踏器有氧運動與一般功能性訓練為主。結果顯示:(1)步行組(17位)平均年齡61.18±12.91歲(範圍為34-81歲),平均發病日期2.17±2.24年(範圍為0.5-10.0)年。輪椅組(11位)平均年齡為55.55±12.13歲(範圍為30-73歲),平均發病日期5.61±6.96年(範圍為1.0-25年)。 (2)步行組ALSFRS于觀察期明顯退步(P=0.036);治療期無明顯改變(P=0.27);追蹤期明顯退步(P=0.006)。 輪椅組以觀察期、治療期、追蹤期皆無明顯改變(P>0.05)。(3)步行組日常生活功能(BI)與姿勢控制(PASS)在觀察期與治療期期間,雖無明顯差异,但在追蹤期明顯退步。(4)輪椅組以統計分析其日常生活功能、姿勢控制及生活品質(SF-36),在觀察、治療與追蹤三期間雖無明顯差异,但其在治療期中的維持功能的人數增加。結論:一周一次6次的居家物理治療對部份肌肉萎縮性側索硬化症患者,可達到減少惡化或維持其生體與心理功能之目標。
Purpose: To develop the care pattern and to investigate the effect of home physical therapy on the functional ability and quality of life in individuals with amyotrophic lateral sclerosis (ALS). Methods: Subjects diagnosed as ALS and lived in Taipei and Keelung area were selected and classified as mild (ambulatory group) and moderate-severe (wheelchair group). This experiment used an A-B-A design with A-period as observation (1.5 months), B-period as treatment (1.5 months) and a second A-period as follow-up (1.5 months). Assessments included Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), Barthel Index (BI), Postural Assessment Scale (PASS), and Quality of life (SF-36). Home physical therapy was performed once a week for 1.5 months and the treatment programs included thera-band low resistance exercise, leg paddling aerobic exercise and basic functional activity training. Results: (1)The mean age of ambulatory group (N=17) was 61.18±12.9lyears old(range: 34-8 1), and the duration of illness was 2.17±2.24 years (range:0.5-10.0). The mean age of wheelchair group (N=11) was 55.55±12.13 years old (range:30-73), and the duration of illness was 5.61±6.96 years(range:1.0-25). (2)The ALSFRS was significantly decreased during observation and follow-up periods (p=0.036 & 0.006 respectively); no significant change during treatment period (p=0.27). However, the wheelchair group did not show significant changes in observation, treatment and follow-up periods. (3)The BI and PASS were not significantly changed during observation period but was significantly decreased during follow-up in the ambulatory group. (4)The BI, PASS and SF36 in wheelchair group did not show significant change in all periods, but the person who could maintain the previous ability levels were increased. Conclusions: The home physical therapy once a week for 6 weeks could maintain or even refard the deterioration of the physical and mental function in some individuals with ALS.


    

本卷期目次
物理治療 29卷6期 (2004.12)
Training Effect of Pedaling Exercise in Stroke Patients: A Single Subject Study Design/ Miao-Ju YenSang-I Lin
門診運動訓練對冠狀動脈繞道手術病患品質調整存活時間之影響/ 洪素鶯吳英黛曹昭懿週正亮楊銘欽王水深
肌肉萎縮性側索硬化症之居家物理治療服務模式之建立與其療效:初步結果/ 林光華胡名霞簡文仁楊智超蔡清標鄭悅承蔡美文
失能者輔具使用現況之初測報告/ 胡名霞柯志昌柴惠敏吳英黛
長期照護個案行動輔具使用調查報告/ 胡名霞
The Role of Specific Stabilization Training in the Management of Lumbar Clinical Instability/ Rick ChiangYu-Shiow Horng
跑步機合併縣吊系統於社經系統損傷患者步行訓練之效果/ 劉娟妃成戎珠
 
   
 
   

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