Volume 39 Issue 12
Dec.  2023
Turn off MathJax
Article Contents
Zhao HY,Han JT,Hu DH,et al.A randomized controlled trial on the effect of exercise prescription based on a progressive mode in treating elderly patients with lower limb dysfunction after deep burns[J].Chin J Burns Wounds,2023,39(12):1122-1130.DOI: 10.3760/cma.j.cn501225-20230721-00012.
Citation: Zhao HY,Han JT,Hu DH,et al.A randomized controlled trial on the effect of exercise prescription based on a progressive mode in treating elderly patients with lower limb dysfunction after deep burns[J].Chin J Burns Wounds,2023,39(12):1122-1130.DOI: 10.3760/cma.j.cn501225-20230721-00012.

A randomized controlled trial on the effect of exercise prescription based on a progressive mode in treating elderly patients with lower limb dysfunction after deep burns

doi: 10.3760/cma.j.cn501225-20230721-00012
Funds:

Shaanxi Provincial Key Research and Development Plan 2022SF-279

More Information
  •   Objective   To explore the effect of exercise prescription based on a progressive mode in treating elderly patients with lower limb dysfunction after deep burns.   Methods   A randomized controlled trial was conducted. From January 2021 to January 2023, 60 elderly patients with lower limb dysfunction after deep burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University. The patients were divided into conventional rehabilitation group (30 cases, 17 males and 13 females, aged (65±3) years) and combined rehabilitation group (30 cases, 16 males and 14 females, aged (64±3) years) according to the random number table. For patients in both groups, the red-light treatment was started after the lower limb wounds healed or when the total area of scattered residual wounds was less than 1% of the total body surface area. After 2 weeks of red-light treatment, the patients in conventional rehabilitation group were given conventional rehabilitation treatments, including joint stretching, resistance, and balance training; in addition to conventional rehabilitation treatments, the patients in combined rehabilitation group were given exercise prescription training based on a progressive mode three times a week, mainly including dumbbell press, Bobath ball horizontal support, and high-level pulldown trainings. The training time for patients in both groups was 12 weeks. Before training (after 2 weeks of red-light treatment) and after 12 weeks of training, the upper limb and lower limb motor functions of the patients were evaluated using the simple Fugl-Meyer scale, the physical fitness of patients was evaluated using the simple physical fitness scale, and the patient's risk of falling was evaluated by the time consumed for the timed up and go test. The adverse events of patients that occurred during training were recorded. After 12 weeks of training, a self-designed satisfaction survey was conducted to investigate patients' satisfaction with the training effect. Data were statistically analyzed with independent sample ttest, paired sample t test, Mann-Whitney U test, Wilcoxon signed rank test, and chi-square test.   Results   Before training, the scores of upper limb and lower limb motor functions of patients between the two groups were similar ( P>0.05). After 12 weeks of training, the scores of upper limb motor function of patients in conventional rehabilitation group and combined rehabilitation group were significantly higher than those before training (with t values of -11.42 and -13.67, respectively, P<0.05), but there was no statistically significant difference between the two groups ( P>0.05). The score of lower limb motor function of patients in combined rehabilitation group was 28.9±2.6, which was significantly higher than 26.3±2.6 in conventional rehabilitation group ( t=-3.90, P<0.05), and the scores of lower limb motor function of patients in conventional rehabilitation group and combined rehabilitation group were significantly higher than those before training (with t values of -4.14 and -6.94, respectively, P<0.05). Before training, the individual and total scores of physical fitness of patients between the two groups were similar ( P>0.05). After 12 weeks of training, the balance ability score, walking speed score, chair sitting score, and total score of physical fitness of patients in conventional rehabilitation group and combined rehabilitation group were significantly increased compared with those before training (with Z values of -4.38, -3.55, -3.88, -4.65, -4.58, -4.68, -4.42, and -4.48, respectively, P<0.05), and the balance ability score, walking speed score, chair sitting score, and total score of physical fitness of patients in combined rehabilitation group were significantly increased compared with those in conventional rehabilitation group (with Z values of -3.93, -3.41, -3.19, and -5.33, P<0.05). Before training, the time consumed for the timed up and go test for patient's risk of falling in the two groups was close ( P>0.05). After 12 weeks of training, the time consumed for the timed up and go test for patient's risk of falling in combined rehabilitation group was (28.0±2.1) s, which was significantly shorter than (30.5±1.8) s in conventional rehabilitation group ( t=4.94, P<0.05). Moreover, the time consumed for the timed up and go test for patient's risk of falling in both conventional rehabilitation group and combined rehabilitation group was significantly shorter than that before training (with t values of 14.80 and 15.86, respectively, P<0.05). During the training period, no adverse events such as muscle tissue strain, edema, or falling occurred in any patient. After 12 weeks of training, the satisfaction score of patients with the training effect in combined rehabilitation group was 13.5±1.2, which was significantly higher than 8.5±1.4 in conventional rehabilitation group ( t=21.78, P<0.05).   Conclusions   The exercise prescription training based on a progressive mode can significantly promote the recovery of lower limb motor function and physical fitness of elderly patients with lower limb dysfunction after deep burns, and effectively reduce the patient's risk of falling without causing adverse events during the training period, resulting in patient's high satisfaction with the training effect.

     

  • loading
  • [1]
    王晓东,马丽,王德洪,等.老年人身体形态、机能及素质与中医体质类型的相关性研究[J].中国运动医学杂志,2012,31(10):907-912.DOI: 10.3969/j.issn.1000-6710.2012.10.012.
    [2]
    陈伟,张梓晨,王若宇,等.471例老年烧伤住院患者的临床资料分析[J].昆明医科大学学报,2023,44(2):88-97.DOI: 10.12259/j.issn.2095-610X.S20230202.
    [3]
    杨长发,闵定宏,郭光华.老年烧伤感染的防治研究进展[J].中华烧伤与创面修复杂志,2023,39(3):285-289.DOI: 10.3760/cma.j.cn501225-20220321-00078.
    [4]
    WangW,ZhangJ,LvY,et al.Epidemiological investigation of elderly patients with severe burns at a major burn center in Southwest China[J].Med Sci Monit,2020,26:e918537.DOI: 10.12659/MSM.918537.
    [5]
    YangSX,ChengS,SuDL.Sports injury and stressor-related disorder in competitive athletes: a systematic review and a new framework[J/OL].Burns Trauma,2022,10:tkac017[2023-07-21].https://pubmed.ncbi.nlm.nih.gov/35702266/.DOI: 10.1093/burnst/tkac017.
    [6]
    KhaiyatOA,NorrisJ.Electromyographic activity of selected trunk, core, and thigh muscles in commonly used exercises for ACL rehabilitation[J].J Phys Ther Sci,2018,30(4):642-648.DOI: 10.1589/jpts.30.642.
    [7]
    佟琳,张万福,胡晓龙,等.腹部不同位置全厚皮片修复小儿功能部位皮肤软组织缺损的前瞻性随机对照研究[J].中华烧伤与创面修复杂志,2022,38(8):744-752.DOI: 10.3760/cma.j.cn501120-20210709-00243.
    [8]
    赵海洋,刘佳琦,韩军涛,等.渐进式核心肌群训练联合下肢智能康复训练对烧伤患者下肢功能障碍影响的前瞻性随机对照研究[J].中华烧伤与创面修复杂志,2022,38(12):1117-1125.DOI: 10.3760/cma.j.cn501225-20220616-00236.
    [9]
    中国老年医学学会烧创伤分会.烧伤后关节功能障碍的预防与康复治疗专家共识(2021版)[J/CD].中华损伤与修复杂志(电子版),2021,16(4):277-282.DOI: 10.3877/cma.j.issn.1673-9450.2021.04.001.
    [10]
    岳梦艳,袁淑娟.血流限制训练在神经系统疾病中的应用进展[J].中国康复,2023,38(6):380-384.DOI: 10.3870/zgkf.2023.06.013.
    [11]
    EmirzeoğluM,ÜlgerÖ.The acute effects of cognitive-based neuromuscular training and game-based training on the dynamic balance and speed performance of healthy young soccer players: a randomized controlled trial[J].Games Health J,2021,10(2):121-129.DOI: 10.1089/g4h.2020.0051.
    [12]
    陈适,郭晓湲,潘慧.循证化、精准化运动处方的制定和意义[J].中华行为医学与脑科学杂志,2023,32(6):488-492.DOI: 10.3760/cma.j.cn371468-20230221-00079.
    [13]
    中华医学会烧伤外科学分会,中国医师协会烧伤科医师分会.烧伤康复治疗指南(2013版)[J].中华烧伤杂志,2013,29(6):497-504.DOI: 10.3760/cma.j.issn.1009-2587.2013.06.001.
    [14]
    HuangZ,TangG,KumarA,et al.A kinematic data based lower limb motor function evaluation method for post-stroke rehabilitation[J].Annu Int Conf IEEE Eng Med Biol Soc,2021,2021:7288-7291.DOI: 10.1109/EMBC46164.2021.9629887.
    [15]
    Navarrete-VillanuevaD,Gómez-CabelloA,Marín-PuyaltoJ,et al.Frailty and physical fitness in elderly people: a systematic review and meta-analysis[J].Sports Med,2021,51(1):143-160.DOI: 10.1007/s40279-020-01361-1.
    [16]
    中华医学会老年医学分会护理学组,中国老年保健医学研究会老年医学护理分会,中国老年护理联盟,等.老年人失能预防运动干预临床实践指南(2023版)[J].中国全科医学,2023,26(22):2695-2710,2714.DOI: 10.12114/j.issn.1007-9572.2023.0223.
    [17]
    仲伟,史淑霞,秦沁悦,等.临床研究协调员工作能力与工作量的测量工具及合理性评估[J].中国临床药理学与治疗学,2023,28(8):937-947.DOI: 10.12092/j.issn.1009-2501.2023.08.010.
    [18]
    TongX,LuJ,ZhangW,et al.Efficacy and safety of external tissue expansion technique in the treatment of soft tissue defects: a systematic review and meta-analysis of outcomes and complication rates[J/OL].Burns Trauma,2022,10:tkac045[2023-07-21].https://pubmed.ncbi.nlm.nih.gov/36518877/.DOI: 10.1093/burnst/tkac045.
    [19]
    TapkingC,PoppD,HerndonDN,et al.Cardiac dysfunction in severely burned patients: current understanding of etiology, pathophysiology, and treatment[J].Shock,2020,53(6):669-678.DOI: 10.1097/SHK.0000000000001465.
    [20]
    JeschkeMG,PhelanHA,WolfS,et al.State of the science burn research: burns in the elderly[J].J Burn Care Res,2020,41(1):65-83.DOI: 10.1093/jbcr/irz163.
    [21]
    胡敏,陈晓娟,任琳洁,等.成年烧伤患者恐动症发生现状及其影响因素的横断面调查[J].中华烧伤杂志,2021,37(6):575-581.DOI: 10.3760/cma.j.cn501120-20200618-00313.
    [22]
    《运动处方中国专家共识(2023)》专家组.运动处方中国专家共识(2023)[J].中国运动医学杂志,2023,42(1):3-13.DOI: 10.3969/j.issn.1000-6710.2023.01.001.
    [23]
    李翠查,徐蕊,宋淑华.渐进性抗阻运动对老年人体适能及跌倒风险的干预研究[J].中国老年保健医学,2022,20(5):41-45.DOI: 10.3969/j.issn.1672-2671.2022.05.011.
    [24]
    吴延,王广玲,聂作婷,等.2022年版《世界指南:老年人跌倒的预防与管理》解读[J].中国全科医学,2023,26(10):1159-1163,1171.DOI: 10.12114/j.issn.1007-9572.2022.0842.
    [25]
    罗曦娟,李新,张献博,等.慢性疾病运动处方新进展[J].中国运动医学杂志,2023,42(8):658-664.DOI: 10.3969/j.issn.1000-6710.2023.08.013.
    [26]
    杨延平,邱俊强,陈演,等.个性化渐进式运动处方对老年女性平衡能力和下肢肌肉力量的影响[J].中国慢性病预防与控制,2020,28(10):785-788.DOI: 10.16386/j.cjpccd.issn.1004-6194.2020.10.016.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(3)

    Article Metrics

    Article views (405) PDF downloads(28) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return