《中国康复理论与实践》

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (10): 1150-1158.doi: 10.3969/j.issn.1006-9771.2022.10.005

• 专题 健康与康复服务 • 上一篇    下一篇

基于ICF构建药物依赖人群功能分析与社区居家运动康复方案研究

郁天成1,王国祥1,2()   

  1. 1.苏州大学体育学院/运动康复研究中心,江苏苏州市 215021
    2.世界卫生组织国际分类家族中国合作中心,北京市 100068
  • 收稿日期:2022-09-16 修回日期:2022-09-22 出版日期:2022-10-25 发布日期:2022-11-08
  • 通讯作者: 王国祥 E-mail:kwang63@163.com
  • 作者简介:郁天成(1995-),男,汉族,江苏南通市人,博士研究生,主要研究方向：ICF,运动戒毒。|王国祥(1963-),男,汉族,教授,博士研究生导师,主要研究方向：ICF、运动康复和康复体育。
  • 基金资助:
    国家社会科学基金项目(19BTY125)

Development of functioning and community-based rehabilitation protocol for drug dependent population using ICF

YU Tiancheng1,WANG Guoxiang1,2()   

  1. 1. School of Physical Education and Sport Sciences/Research Center of Sport and Exercise Rehabilitation, Soochow University, Suzhou, Jiangsu 215021, China
    2. WHO Family of International Classifications Collaborating Center in China, Beijing 100068, China
  • Received:2022-09-16 Revised:2022-09-22 Published:2022-10-25 Online:2022-11-08
  • Contact: WANG Guoxiang E-mail:kwang63@163.com
  • Supported by:
    National Social Science Fund of China(19BTY125)

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摘要：

目的 应用《国际功能、残疾和健康分类》(ICF)理论与方法对药物依赖人群的心理健康和功能状态进行分析,构建居家运动康复的理论架构、康复方案和实施方案。

方法 运用《国际疾病分类》(ICD-11)和ICF对药物依赖者的身体功能(认知、运动)、活动和参与进行系统分析。运用世界卫生组织(WHO) ICF“生物-心理-社会”的功能、残疾和健康模式以及《WHO关于身体活动和久坐行为的指南》,构建适用于药物依赖人群的居家运动康复方案。

结果 药物依赖人群在身体功能方面的障碍涉及精神功能方面(b1),表现为认知功能受损、情绪控制能力下降、记忆功能受损、思维迟钝和人格障碍等,同时长期用药引发一系列并发症,主要表现在心肺功能(b4)和运动功能(b7)的部分障碍;在活动和参与方面,主要表现为学习和应用知识(d1),一般任务和要求(d2),自理(d5),人际交往和人际关系(d7),社区、社会和公民生活(d9)等活动受限和参与局限。身体活动有利于药物依赖人群改善精神功能,有效提升认知、注意力、情绪、思维等能力。药物依赖人群的运动康复方案建议每周进行4~5次、共计150~300 min的中等强度有氧运动,包括散步、太极拳、瑜伽等;或每周2~3次、共计75~150 min的高强度有氧运动,包括跑步、跳绳、羽毛球、乒乓球、武术等;或每周2~3次、每次30~60 min的中等强度或高强度抗阻运动,如俯卧撑、引体向上、仰卧起坐等主要肌肉群活动。药物依赖人群居家运动康复应融入社区健康服务连续体,覆盖预防、治疗、康复和健康促进四个方面。可以通过线下指导(专业指导、小组指导、自我指导)和线上指导(视频教学、远程在线指导、云监督)的形式,为药物依赖人群提供居家运动康复服务。

结论 运用ICD-11和ICF对药物依赖人群的健康状况和功能状态进行系统分析,基于“生物-心理-社会”的功能、残疾和健康模式,构建了基于功能导向和整体健康的理论,构建居家康复的理论架构和方案。通过居家运动康复,促进药物依赖人群认知、运动、活动和参与功能恢复,帮助其重返家庭和社会。

关键词: 国际功能、残疾和健康分类, 药物依赖, 运动康复

Abstract:

Objective To analyze the mental health and functional status of drug-dependent population by applying the theory and method of International Classification of Functioning, Disability and Health (ICF), explore the physical activity on the mental health pattern of drug-dependent population, and construct a theoretical framework, rehabilitation protocol and implementation plan for home exercise rehabilitation.

Methods The International Classification of Diseases (ICD-11) and ICF were used to systematically analyze the physical dysfunction (cognitive and motor), activity and participation of drug-dependent population. Based on the ICF bio-psycho-social model of functioning, disability and health, and with reference to the WHO Guidelines on Physical Activity and Sedentary Behavior, a home exercise rehabilitation program was constructed for the functional rehabilitation of drug-dependent population.

Results Functional impairment in the drug-dependent population was manifested in the physical function element mainly in mental dysfunction (b1), impaired cognitive function, reduced emotional control, impaired memory function, slowed thinking and personality disorders; while long-term drug use triggered a series of comorbidities, mainly in cardiopulmonary function (b4) and partial impairment of motor function (b7); and in the activity and participation element, learning and applying knowledge (d1), general tasks and demands (d2), self-care (d5), interpersonal and intrapersonal interactions (d7), and community, social, and civic life (d9) were limited. Physical activity was beneficial for the drug-dependent population to improve mental health, including cognition, attention, emotion, and thinking. A function-based exercise rehabilitation protocol was established. It recommended a programe of moderate intensity aerobic exercise, including walking, Tai Chi, Yoga, etc., four to five times a week for 150 to 300 minutesp; or high intensity aerobic exercise, including running, rope skipping, badminton, table tennis, martial arts, etc., two to three times a week for 75 to 150 minutes; moderate-intensity or high-intensity resistance exercises, such as push-ups, pull-ups, sit-ups and other major muscle group activities, two to three times a week with 30 to 60 minutes per time. The program of home exercise rehabilitation for drug-dependent population should be integrated into the four aspects of prevention, treatment, rehabilitation and health promotion in the community health service continuum, and provide home exercise rehabilitation services through offline guidance (professional guidance, group guidance, self-guidance) and online guidance (video instruction, remote online guidance, cloud supervision).

Conclusion A systematic analysis of the health condition and functional status of drug-dependent population has been conducted using ICD-11 and ICF, and a functional-oriented and holistic health-based home rehabilitation protocol has been developed based on the ICF bio-psycho-social model of functioning, disability and health, which may promote the recovery of cognitive, motor, activity, and participation functions of drug-dependent population, and help them reintegrate into family and society.

Key words: International Classification of Functioning, Disability and Health, drug dependence, exercise rehabilitation

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