推拿联合作业训练对卒中后认知障碍患者上肢运动及认知功能的康复效果OA

Objective:To investigate the rehabilitative effects of a combined Tuina(Chinese therapeutic massage)and occupational therapy(OT)approach on upper-limb motor function,activities of daily living(ADL),cognitive function,and fatigue severity in patients with poststroke cognitive impairment(PSCI). Methods:Seventy patients with PSCI were randomly divided into an OT group and a joint group using the random number table method,with 35 cases in each group.Both groups received secondary prevention for stroke.The OT group received occupational training,including training in ADL,upper-limb function,fine motor skills of the hands,and cognitive function;the joint group received Tuina treatment in addition to the interventions in the OT group.Both groups received treatment once daily,5 d a week,with 2 d of rest,for 4 consecutive weeks.The changes in the scores of the Fugl-Meyer assessment scale for upper extremity(FMA-UE),modified Barthel index(MBI),Montreal cognitive assessment scale(MoCA),and fatigue severity scale(FSS)were observed in both groups after treatment. Results:During the trial,2 patients dropped out of each group,and 33 patients completed the study in each group.After treatment,the FMA-UE,MBI,and MoCA total scores,as well as the scores of five dimensions of visuospatial executive function,attention,verbal fluency,delayed memory,and orientation,increased in both groups(P<0.05).The FSS score decreased in the joint group(P<0.01)and was lower than that in the OT group(P<0.01).The FMA-UE score,MBI score,MoCA total score,and the sub score of the visuospatial executive function in the joint group were all higher than those in the OT group(P<0.05). Conclusion:Compared with OT alone,a combined approach of Tuina and OT can improve the fatigue level in patients with PSCI,enhance their ADL,and achieve superior rehabilitation outcomes in terms of upper-limb motor function and cognitive function,particularly visuospatial executive function.