中国康复理论与实践2023，Vol.29Issue(12)：1395-1404,10.DOI:10.3969/j.issn.1006-9771.2023.12.004
脊髓损伤患者适应性身体活动及其健康效益:基于ICF的Scoping综述
Adaptive physical activity and its health benefits for patients with spinal cord injury based on ICF:a scoping re-view
摘要
Abstract
Objective To analyze adaptive physical activity interventions and their health benefits for patients with spinal cord inju-ry(SCI)based on International Classification of Functioning,Disability and Health(ICF). Methods A combination of subject headings and free words was employed to search for relevant literature on physical activity in patients with SCI in PubMed,Web of Science,EBSCO and CNKI,from January,2017 to July,2022.A scoping review was conducted. Results Eight English articles were included,from Australia,the United States,Estonia,Canada,Netherlands and Brazil.The study involved 150 patients with SCI and included seven randomized controlled trials and one non-random-ized controlled trial.These literatures were primarily from journals in the fields of SCI,neurology,neuromuscu-lar medicine and physical activity,with publication dates concentrated between 2017 and 2021.The included studies involved participants with complete or incomplete SCI,presenting with paraplegia,tetraplegia,and vari-ous levels of injury severity(grades A to D).The main functional disorders related to ICF included b710 mobility of joint functions,b715 stability of joint functions,b720 mobility of bone functions,b730 muscle power func-tions,b735 muscle tone functions,b750 motor reflex functions,b760 control of voluntary movement functions and b770 gait pattern functions;the functions involved in activities and participation included d410 changing ba-sic body position,d415 maintaining a body position,d420 transferring oneself,d445 hand and arm use,d450 walking,d455 moving around,d570 looking after one's health,d610 acquiring a place to live,d910 community life,d920 recreation and leisure;the environmental factors involved were e1151 assistive products and technolo-gy for personal use in daily living,and e1401 assistive products and technology for culture,recreation and sport.Physical activity intervention sites mainly included home,community,medical or rehabilitation institutions.The physical activity could be classified into prevention,health promotion,treatment and rehabilitation.Patients with SCI had completed acute and subacute rehabilitation in medical and rehabilitation institutions,and returned to their families and communities,and some of them received services in medical and rehabilitation institutions from time to time.The forms of physical activity included strength training combined with routine nursing,short-term resistance training,hydrotherapy and robot treadmill activities,functional electrical stimulation and thera-peutic exercise,progressive exercise training based on exoskeleton of power machine,leg bicycle assisted by electrical stimulation combined with manual bicycle,and acute exercise with different intensity.The activity fre-quency was twelve to 60 minutes a time,two to three times a week,lasting for three to 16 weeks,and the activity intensity was mainly medium to high.The health benefits of physical activity on patients with SCI were mainly reflected in four aspects:physical and mental health,activity and behavior health,environmental factors,quality of life and well-being.In terms of physical and mental health,it helped to improve muscle function(muscle strength,strength perception),walking function(walking speed,walking distance),respiratory and circulatory system functions(peak oxygen uptake,aerobic endurance,cardiopulmonary function,reducing the risk of cardio-pulmonary diseases,etc.),immune system related functions,and improving psychosocial function(fatigue de-gree).In terms of activity and behavioral health,it was helpful to improve activity skills and abilities.In terms of environmental factors,the availability and effectiveness of some auxiliary equipment were confirmed.In terms of quality of life and well-being,it could improve self-living ability and quality of life. Conclusion This study established a PICO framework for adaptive physical activity and its health effects in patients with SCI based on ICF.Physical activity for patients with SCI can be conducted in various settings,including home,community,or medical and rehabilitation institutions.The physical activities of patients with SCI are character-ized by wheelchair-based adaptive physical activities,which are mainly divided into two categories:various aero-bic exercises and resistance exercises based on wheelchairs,and physical activities based on auxiliary exercise equipment or intervention methods(such as robot treadmill,power machine exoskeleton,functional electrical stimulation,etc.).The frequency of physical activity in patients with SCI is twelve to 60 minutes a time,two to three times a week,lasting for three to 16 weeks,and the activity intensity is maily medium to high.Therapists and rehabilitation professionals can provide guidance and support through various means,such as online or of-fline supervision and one-on-one coaching,to promote the health benefits of physical activity for patients with SCI,including improved physical and psychological function,enhanced activity levels,reduced sedentary behav-ior,and increased self-care abilities and quality of life.关键词
脊髓损伤/身体活动/适应性体育/Scoping综述Key words
spinal cord injury/physical activity/adaptive sports/scoping review分类
医药卫生引用本文复制引用
石孝宇,杨剑..脊髓损伤患者适应性身体活动及其健康效益:基于ICF的Scoping综述[J].中国康复理论与实践,2023,29(12):1395-1404,10.基金项目
教育部人文社科研究项目(No.22YJA890032) Supported by Humanities and Social Sciences Research Project of Ministry of Education(No.22YJA890032) （No.22YJA890032）
