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康复临床实践指南·脑卒中患者立位平衡障碍OACSTPCD

Clinical Rehabilitation Practice Guidelines on Standing Balance Disorder in Patients with Stroke

中文摘要英文摘要

脑卒中立位平衡障碍是指患者在站立时出现的平衡问题,难以在静止或运动状态下维持稳定,包括站立不稳、摇摆、容易摔倒等,严重影响患者步行及日常生活活动.物理治疗和传统中医治疗是提高脑卒中患者立位平衡功能的有效康复方法.为规范脑卒中立位平衡障碍康复的评定与治疗,提高其物理治疗和传统中医治疗的康复诊疗规范,专家组整理德尔菲法汇总后的趋同性意见形成脑卒中立位平衡障碍康复临床实践指南草案,采用共识会议法,编制本指南.本指南从技术范围、规范性引用文件、术语和定义(平衡、支撑面、质心、重心、稳定极限、本体感觉、前庭功能、视觉、前庭眼反射、立位平衡功能、立位平衡障碍、核心稳定、平衡策略)、康复评估(临床表现、临床评估、特殊评估、视觉功能评估、协调功能评估)、康复治疗(前庭功能训练、感觉功能训练、视觉功能训练、运动功能训练、协调功能训练、共济失调训练、心理治疗、运动治疗、双重任务训练、虚拟现实技术、非侵入性神经调控技术、康复机器人、水疗、视觉反馈平衡训练、传统康复治疗、医疗体操)和效果评价进行规范制定.本指南可为脑卒中立位平衡障碍康复治疗提供规范化诊治流程,并为临床实践提供可靠的证据参考,具有良好的临床适用性及可操作性.

Standing balance disorder in stroke refers to the difficulty a patient experiences in maintaining static and dynamic balance while standing,including standing instability,swaying,and a higher risk of falling.It seriously affects the patient's ability of walking and activities of daily living.Physical therapy and traditional Chinese treatment are effective rehabilitation methods for improving standing balance function in stroke patients.For standardized assessment and application of physical therapy and tradi-tional Chinese treatment on standing balance,an expert panel compiled a draft of clinical practice guidelines for standing balance impairment rehabilitation in stroke based on the Delphi method of summarizing consensus opinions,and was modified and formu-lated to guideline after consensus conference.This guideline covers the technical scope of practice,normative reference documents,terms and definitions(balance,base of support,center of mass,center of gravity,limits of stability,proprioception,vestibular func-tion,visual sense,vestibulo-ocular reflex,standing balance function,standing balance disorder,core stability,balance strategy),reha-bilitation assessments(clinical manifestation,clinical evaluations,special assessments related to balance function,visual and co-ordination function assessment),rehabilitation treatments(vestibular function training,sensory function training,visual function training,motor function training,coordination and dystaxia training,psychotherapy,kinesitherapy,dual task training,virtual reality technique,non-invasive neural regulation technology,rehabilitation robot,hydrotherapy,visual feedback balance training,traditional rehabilitation therapy and medical gymnastics)and evaluations of therapeutic efficiency.This guideline can provide standardized diagnosis and treatment procedures for rehabilitation treatment of standing balance disorder in stroke patients and evidence reference for clinical decision-making practice,with good clinical applicability and practicability.

沈滢;汤从智;王红星;殷稚飞;孟殿怀;苏敏;何坚;兰月;王楚怀;邹俊;江山

南京医科大学第一附属医院,江苏 南京 210029东南大学附属中大医院,江苏 南京 210009苏州大学附属第四医院,江苏 苏州 215123漳州卫生职业学院,福建 漳州 363000广州市第一人民医院,广东 广州 510180中山大学附属第一医院,广东 广州 510062苏州大学附属第一医院,江苏 苏州 215006中日友好医院,北京 100029

脑卒中平衡障碍立位平衡指南康复传统康复治疗

strokebalance disorderstanding balanceguidelinerehabilitationtraditional rehabilitation treatment

《康复学报》 2024 (003)

195-210 / 16

国家重点研发计划项目(2022YFC2009700)

10.3724/SP.J.1329.2024.03001

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