职业能力训练与评估系统对上肢损伤工伤患者的疗效

doi:10.3969/j.issn.1006-9771.2018.01.021

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (1): 107-111.doi: 10.3969/j.issn.1006-9771.2018.01.021

职业能力训练与评估系统对上肢损伤工伤患者的疗效

陆佳妮, 白钟飞, 史晓宇, 舒甜, 王惠芳

上海市养志康复医院(上海市阳光康复中心)作业治疗科,上海市 201619

收稿日期:2017-10-07 修回日期:2017-12-26 出版日期:2018-01-25 发布日期:2018-01-31
通讯作者: 王惠芳,女,副主任医师;E-mail:304whf@163.com。
作者简介:陆佳妮(1983-),女,汉族,上海市人,硕士,主管治疗师,主要研究方向：神经康复和工伤职业康复。
基金资助:
上海市残联系统优秀康复人才培养项目(No. 2014KFB06YQ)

Effects of Baltimore Therapeutic Equipment on Traumatic Upper Extremity Injury from Work

LU Jia-ni, BAI Zhong-fei, SHI Xiao-yu, SHU Tian, WANG Hui-fang

Occupational Therapy Department, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai 201619, China

Received:2017-10-07 Revised:2017-12-26 Published:2018-01-25 Online:2018-01-31
Contact: WANG Hui-fang.E-mail:304whf@163.com
Supported by:
Excellent Rehabilitation Personnel Training Project of Shanghai Federation of Disabled Persons (No.2014KFB06YQ)

摘要/Abstract

摘要： 目的将职业能力训练与评估系统(BTE)应用于上肢损伤工伤患者的康复,观察其疗效。方法 2014年9月至2015年8月住院接受康复治疗的手或上肢损伤患者为对照组(n=42),2015年9月至2016年8月住院接受康复治疗患者为实验组(n=36)。在常规康复治疗的基础上,对照组接受常规模拟训练,实验组接受BTE模拟训练,共4周。训练前后采用BTE测试患者立位双肘提举力、蹲位提举力、动态搬运至腰部、动态搬运至肩部、患手握力、健手握力,采用上肢功能障碍评定量表(DASH)进行评定;出院半年后,电话随访患者复工状态。结果治疗后,实验组较对照组立位双肘提举力(t=4.290, P<0.001)、蹲位提举力(t=2.645, P=0.010)、动态搬运至腰部(t=2.639, P=0.010)、动态搬运至肩部(t=5.361, P<0.001)、患侧握力(t=2.320, P=0.023)、健侧握力(t=3.130, P=0.002)均增强,两组DASH评分(t=-0.851, P=0.398)和复工状态(χ²=0.05, P=0.944)无显著性差异。结论 BTE能有效改善上肢损伤工伤患者的功能状态。但需更多关注其他因素对患者复工的影响。

关键词: 工伤, 职业康复, 复工, 工作模拟, 职业能力训练与评估系统

Abstract: Objective To apply the Baltimore Therapeutic Equipment (BTE), a kind of vocational training and evaluation system, in rehabilitaion of patients post traumatic upper extremity injury from work, and to observe the effects.Methods Inpatients from September, 2014 to August, 2015 for rehabilitation of traumatic upper extremity injury from work were selected as control group (n=42), and inpatients from September, 2015 to August, 2016 were selected as intervention group (n=36). Both groups received routine rehabilitation, while the control group received conventional work simulation training, and the intervention group received work simulation training with BTE, for four weeks. They were measured the standing lifting strength (elbow), squatting lifting strength, dynamic lifting strength (floor to waist), dynamic lifting strength (floor to shoulder), and grip strength of the injured hand and the healthy hand with BTE, before and after rehabilitation; while they were assessed with Disability of Arm Shoulder and Hand (DASH). The incidence of return to work was investigated at six months of follow-up.Results The standing lifting strength (elbow) (t=4.290, P<0.001), squatting lifting strength (t=2.645, P=0.010), dynamic lifting strength (floor to waist) (t=2.639, P=0.010), dynamic lifting strength (floor to shoulder) (t=5.361, P<0.001), and grip strength of the injured hand (t=2.320, P=0.023) and the healthy hand (t=3.130, P=0.002) improved better in the intervention group than in the control group after rehabilitation. However, there was no significant difference between two groups in score of DASH (t=-0.851, P=0.398), as well as incidence of return to work (χ²=0.05, P=0.944).Conclusion BTE may help to improve the body function in patients post traumatic upper extremity injury from work. However, vocational rehabilitation should focus on the factors other than body function, to improve their return to work.

Key words: work injury, vocational rehabilitation, return to work, work simulation, Baltimore Therapeutic Equipment

中图分类号:

R658.2

陆佳妮, 白钟飞, 史晓宇, 舒甜, 王惠芳. 职业能力训练与评估系统对上肢损伤工伤患者的疗效[J]. 《中国康复理论与实践》, 2018, 24(1): 107-111.

LU Jia-ni, BAI Zhong-fei, SHI Xiao-yu, SHU Tian, WANG Hui-fang. Effects of Baltimore Therapeutic Equipment on Traumatic Upper Extremity Injury from Work[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(1): 107-111.

参考文献

[1] 胡朝阳,刘鸣江. 手外伤流行病学研究现状[J]. 现代医药卫生, 2014(23): 3568-3570.
[2] 陈守平. 手外伤住院患者5302例的临床特征分析[J]. 实用医学杂志, 2016, 32(9): 1524-1527.
[3] 福嘉欣,江毅,朱红,等. 673例成人职业性手外伤的流行病学调查[J]. 中华劳动卫生职业病杂志, 2015, 33(10): 769-770.
[4] Ferreira J, Fowler JR. Management of complications relating to complex traumatic hand injuries [J]. Hand Clin, 2015, 31(2): 311-317.
[5] Hou WH, Liang HW, Sheu CF, et al. Return to work and quality of life in workers with traumatic limb injuries: a 2-year repeated-measurements study [J]. Arch Phys Med Rehabil, 2013, 94(4): 703-710.
[6] 田万成,潘希贵,潘风雨. 手外伤早期功能康复医生指导方法[J]. 实用手外科杂志, 2014, 28(3): 245-246.
[7] Hou WH, Chi CC, Lo HL, et al. Vocational rehabilitation for enhancing return-to-work in workers with traumatic upper limb injuries [J]. Cochrane Database Syst Rev, 2013, 10(10): CD010002.
[8] 卞立,陈永桃,邵一,等. Valpar职业评估系统在工伤职业康复中的应用进展[J]. 中国康复, 2015, 30(6): 428-431.
[9] Carver RL, Hogstrom KR, Price MJ, et al. Real-time simulator for designing electron dual scattering foil systems [J]. J Appl Clin Med Phys, 2014, 15(6): 4849.
[10] 董新春,何星飞,梁成盼,等. BTE Primus(RS)训练联合Maitland手法治疗踝关节创伤性关节炎的疗效[J]. 实用医学杂志, 2016, 32(7): 1202-1203.
[11] 卢讯文,廖麟荣,徐艳文,等. BTE Primus工作模拟训练系统对手外伤患者重返工作的影响[J]. 中国康复医学杂志, 2015, 30(8): 811-814.
[12] Bertrand AM, Fournier K, Wick Brasey MG, et al. Reliability of maximal grip strength measurements and grip strength recovery following a stroke [J]. J Hand Ther, 2015, 28(4): 356-362.
[13] Chen H, Ji X, Zhang W, et al. Validation of the simplified Chinese (Mainland) version of the Disability of the Arm, Shoulder, and Hand questionnaire (DASH-CHNPLAGH) [J]. J Orthop Surg Res, 2015, 10(1): 76.
[14] Lundquist CB, Dossing K, Christiansen DH. Responsiveness of a Danish version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire [J]. Dan Med J, 2014, 61(4): A4813.
[15] Iordens GIT, Den Hartog D, Tuinebreijer WE, et al. Minimal important change and other measurement properties of the Oxford Elbow Score and the Quick Disabilities of the Arm, Shoulder, and Hand in patients with a simple elbow dislocation; validation study alongside the multicenter FuncSiE trial [J]. PLoS One, 2017, 12(9): e0182557.
[16] Luthi F, Deriaz O, Vuistiner P, et al. Predicting non return to work after orthopaedic trauma: the Wallis Occupational Rehabilitation RisK (WORRK) model [J]. PLoS One, 2014, 9(4): e94268.
[17] 范鹤馨,周永生,缪碧琴. 工伤职工重返岗位与职业康复、社会支持状态关系的探讨[J]. 中国急救医学, 2016, 36(z1):232-233.
[18] De Baets S, Calders P, Schalley N, et al. Updating the evidence on functional capacity evaluation methods: a systematic review [J]. J Occup Rehabil, 2017. [Epub ahead of print]. doi:10.1007/s10926-017-9734-x.
[19] Ramel E, Rosberg HE, Dahlin LB, et al. Return to work after a serious hand injury [J]. Work, 2013,44(4): 459-469.
[20] Shi Q, Sinden K, Macdermid JC, et al. A systematic review of prognostic factors for return to work following work-related traumatic hand injury [J]. J Hand Ther, 2014, 27(1): 55-62.
[21] Roesler ML, Glendon AI, O'callaghan FV. Recovering from traumatic occupational hand injury following surgery: a biopsychosocial perspective [J]. J Occup Rehabil, 2013, 23(4): 536-546.
[22] Hu J, Jiang Y, Liang Y, et al. Predictors of return to work and duration of absence following work-related hand injury [J]. Int J Inj Contr Saf Promot, 2014, 21(3): 216-223.
[23] 蔡素芳. 急性职业性手外伤患者回归工作的影响因素分析[J]. 中国康复, 2015, 30(6): 412-415.
[24] Moshe S, Izhaki R, Chodick G, et al. Predictors of return to work with upper limb disorders [J]. Occup Med, 2015, 65(7): 564-569.
[25] Franchignoni F, Vercelli S, Giordano A, et al. Minimal clinically important difference of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH) and its shortened version (QuickDASH) [J]. J Orthop Sports Phys Ther, 2014, 44(1): 30-39.

职业能力训练与评估系统对上肢损伤工伤患者的疗效

Effects of Baltimore Therapeutic Equipment on Traumatic Upper Extremity Injury from Work

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