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目的探讨奥塔戈运动项目(Otago exercise programme,OEP)对社区中枢性偏瘫患者因恐惧而害怕跌倒的影响。方法选择2014年1月—6月出院的中枢性偏瘫患者61例,将其随机分为试验组30例及对照组31例。试验组患者出院后进行OEP锻炼,对照组未进行OEP锻炼。于所有患者出院前1 d(干预前)及第20周随访(干预后)时进行问卷调查,评价患者恐惧跌倒效能、平衡能力及移动能力等指标。结果干预后,试验组患者完成OEP锻炼依从率为73.3%。干预前,两组修正版跌倒效能量表(modified fall efficacy scale,MFES)得分、Berg平衡量表(Berg balance scale,BBS)得分及起立-行走计时测试(time up and go test,TUGT)时间比较,差异均无统计学意义(P>0.05)。干预后,试验组内MFES得分以及BBS得分均高于干预前(P<0.05),TUGT时间干预后少于干预前(P<0.05);试验组MFES得分以及BBS得分均高于对照组患者(P<0.05),TUGT时间比较差异无统计学意义(P>0.05)。对照组内干预前后MFES得分、BBS得分及TUGT时间比较,差异均无统计学意义(P>0.05)。结论中枢性偏瘫患者出院后进行OEP锻练,可降低患者恐惧跌倒效能,提高患者平衡能力。
Objective To investigate the impact of Otago exercise program (OEP) on fears of fear of falls in patients with central hemiplegia. Methods Sixty-one patients with central hemiplegia who were discharged from January 2014 to June 2014 were randomly divided into experimental group (n = 30) and control group (n = 31). Patients in the test group were discharged after OEP exercise, the control group did not OEP exercise. All patients were surveyed 1 d before intervention (before intervention) and 20 after follow-up (after intervention) to evaluate the efficacy of fear-fall, balance ability and mobility. Results After intervention, the compliance rate of OEP training in the test group was 73.3%. Before the intervention, two groups of modified fall efficacy scale (MFES) score, Berg balance scale (BBS) score and time up and go test (TUGT) were compared , There was no significant difference (P> 0.05). After intervention, MFES scores and BBS scores in the experimental group were higher than those before the intervention (P <0.05), and those in the TUGT time intervention group were less than those before the intervention (P <0.05); MFES scores and BBS scores in the experimental group were higher than those in the control group P <0.05). There was no significant difference in TUGT time (P> 0.05). Before and after the intervention in the control group MFES score, BBS score and TUGT time, the difference was not statistically significant (P> 0.05). Conclusion OEP exercise after discharged from the patients with central hemiplegia can reduce the efficacy of fear and fall and improve the balance ability of patients.