智能工作模拟训练联合活动调试技术对头痛型脑损伤患者职业相关身体功能的效果

doi:10.3969/j.issn.1006-9771.2026.02.011

摘要/Abstract

摘要：

目的评估智能工作模拟训练联合活动调试技术对头痛型脑损伤患者职业相关身体功能的疗效。

方法从2021年1月至2023年12月在广东省工伤康复医院接受治疗的头痛型脑损伤89例患者中，根据采用的治疗方案随机抽取两组，仅接受智能工作模拟训练者为对照组(n = 24)，接受智能工作模拟训练联合活动调试技术干预者为试验组(n = 24)。分别于治疗前和治疗后30 d，采用视觉模拟评分量表(VAS)评定静息状态和模拟工作状态下头痛程度，采用蒙特利尔认知评估量表(MoCA)、Berg平衡量表(BBS)、功能性能力评估量表评估职业相关身体功能；治疗后30 d，采用林氏就业意愿准备量表(LASER)进行评定。记录治疗后3个月就业结局。

结果治疗后，试验组模拟工作状态下VAS显著降低(t = 7.240, P < 0.001)，且显著低于对照组(t = -5.656, P < 0.001)；两组BBS、体力搬抬、工作耐力评分均明显改善(|t| > 3.491, P < 0.01)，且试验组优于对照组(|t| > 2.256, P < 0.05)；两组站-蹲姿势变化、一分钟步行距离、一分钟上下楼梯成绩均改善(|t| > 2.095, P < 0.05)，但两组间无显著性差异(|t| < 1.966, P > 0.05)。试验组就业意愿和复工结局均优于对照组(χ² > 8.254, P < 0.05)。

结论联合活动调试技术能改善头痛型脑损伤患者在工作状态下的头痛问题，进一步提高复杂性特异职业相关身体功能，患者就业意愿更高，复工率更高。

关键词: 智能工作模拟训练, 活动调试技术, 脑损伤, 头痛, 职业康复

Abstract:

Objective To evaluate the effect of intelligent work simulation training combined with activity pacing on occupation-related physical functions in brain injury patients with headache.

Methods A total of 89 brain injury patients with headache received treatment at Guangdong Work Injury Rehabilitation Hospital from January, 2021 to December, 2023. Two groups were randomly selected from 89 patients according to the therapeutic regimens adopted: control group (n = 24) received only intelligent work simulation training, while the experimental group (n = 24) received intelligent work simulation training combined with activity pacing. Before and 30 days after treatment, Visual Analogue Scale (VAS) was used to assess the degree of headache at rest and under simulated working conditions, while Montreal Cognitive Assessment (MoCA), Berg Balance Scale (BBS) and Functional Capacity Evaluation were applied to evaluate the occupation-related physical functions of the patients, respectively. They were assessed with Lam Assessment on Stages of Employment Readiness (LASER) 30 days after treatment. The outcomes of return-to-work were recorded three months after treatment.

Results After treatment, the score of VAS under simulated working conditions decreased in the experimental group (t = 7.240, P < 0.001), and was significantly lower than that in the control group (t = -5.656, P < 0.001); the scores of BBS, manual material handling and work endurance improved in both groups (|t| > 3.491, P < 0.01), and they were better in the experimental group than in the control group (|t| > 2.256, P < 0.05); and the performance of standing-squatting posture transition, 1-minute walking distance and 1-minute stair climbing improved in both groups (|t| > 2.095, P < 0.05), without significant differences between the two groups (|t| < 1.966, P > 0.05). The employment willingness and return-to-work outcomes were better in the experimental group than in the control group (χ² > 8.254, P < 0.05).

Conclusion The combination of activity pacing can alleviate headache under working conditions for brain injury patients with headache, further improve the complex specific occupation-related physical functions, and lead to higher employment willingness and return-to-work rate.

Key words: intelligent work simulation training, activity pacing, brain injury, headache, vocational rehabilitation

中图分类号:

R492

黄茹, 邱梓瑜, 蔡东星, 卢讯文, 高潮铨. 智能工作模拟训练联合活动调试技术对头痛型脑损伤患者职业相关身体功能的效果[J]. 《中国康复理论与实践》, 2026, 32(2): 215-221.

HUANG Ru, QIU Ziyu, CAI Dongxing, LU Xunwen, GAO Chaoquan. Effect of intelligent work simulation training combined with activity pacing on brain injury patients with headache[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 215-221.

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组别	n	性别(男/女)/n	年龄/岁	病程/月	原岗位类型(全体力/半体力/非体力)/n	受伤程度(轻/中/重)/n	文化(小学/初中/高中或中专/大学以上)/n
对照组	24	20/4	39.13±10.96	9.83±5.49	13/5/6	5/6/13	4/6/7/7
试验组	24	19/5	41.25±11.25	8.54±5.41	9/10/5	6/6/12	3/11/4/6
χ²/F值		0.137	0.001	0.203	2.485	0.131	2.509
P值		0.712	0.249	0.416	0.289	0.937	0.474

变量	组别	n	测试	$\bar{x} \pm s$	t值	P值
静息状态	对照组	24	前测	3.25±1.70	1.735	0.096
			后测	3.04±1.46
	试验组	24	前测	2.58±1.25	1.297	0.207
			后测	2.33±1.24
	治疗前两组均值差			-0.67±0.43	-1.548	0.128
	治疗后两组均值差			-0.71±0.39	-1.813	0.076
模拟工作状态	对照组	24	前测	5.58±1.10	-0.582	0.567
			后测	5.00±1.35
	试验组	24	前测	4.58±1.72	7.240	< 0.001
			后测	2.25±1.96
	治疗前两组均值差			-0.25±0.45	-0.557	0.580
	治疗后两组均值差			-2.75±0.49	-5.656	< 0.001

组别	n	测试	$\bar{x} \pm s$	t值	P值
对照组	24	前测	22.67±6.25	-2.015	0.056
		后测	23.17±5.75
试验组	24	前测	25.63±3.73	0.521	0.607
		后测	25.00±5.28
治疗前两组均值差			2.96±1.49	1.992	0.052
治疗后两组均值差			1.83±1.59	1.150	0.257

变量		组别	n	测试	$\bar{x} \pm s$	t值	P值
复杂性特异职业能力	BBS	对照组	24	前测	49.21±3.74	-7.733	< 0.001
				后测	51.38±3.20
		试验组	24	前测	50.46±3.49	-7.570	< 0.001
				后测	53.29±2.66
		治疗前两组均值差			1.25±1.04	1.197	0.580
		治疗后两组均值差			1.92±0.85	2.256	0.029
	体力搬抬	对照组	24	前测	2.42±4.63	-3.491	0.002
				后测	4.04±4.79
		试验组	24	前测	5.29±7.42	-3.909	0.001
				后测	8.63±8.21
		治疗前两组均值差			2.88±1.79	1.611	0.114
		治疗后两组均值差			4.58±1.94	2.363	0.022
	工作耐力	对照组	24	前测	23.13±15.87	-6.626	< 0.001
				后测	31.88±13.74
		试验组	24	前测	31.04±14.74	-5.935	< 0.001
				后测	48.54±16.78
		治疗前两组均值差			7.92±4.42	1.791	0.080
		治疗后两组均值差			16.67±4.43	3.765	< 0.001
单一性一般职业能力	站-蹲姿势变化能力/s	对照组	24	前测	101.75±71.59	2.168	0.041
				后测	91.96±68.85
		试验组	24	前测	72.33±66.71	2.095	0.047
				后测	67.04±67.48
		治疗前两组均值差			-29.42±19.97	-1.473	0.148
		治疗后两组均值差			-24.92±19.68	-1.266	0.212
	一分钟步行/m	对照组	24	前测	46.17±16.62	-5.314	< 0.001
				后测	53.17±14.40
		试验组	24	前测	55.04±16.08	-3.252	0.004
				后测	61.13±13.63
		治疗前两组均值差			8.88±4.72	1.880	0.066
		治疗后两组均值差			7.96±4.05	1.966	0.055
	一分钟上下楼梯/阶	对照组	24	前测	38.67±22.43	-4.232	< 0.001
				后测	45.54±26.01
		试验组	24	前测	51.25±21.81	-3.834	0.001
				后测	59.38±21.87
		治疗前两组均值差			12.58±6.39	1.971	0.055
		治疗后两组均值差			13.83±6.94	1.994	0.052

组别	n	就业意愿(考虑前/考虑/准备/行动)/n	3个月实际复工结局(原岗位/调整任务/调岗位/不复工)/n
对照组	24	8/4/9/3	1/5/9/9
试验组	24	0/9/7/8	9/4/6/5
χ²值		12.446	8.254
P值		0.006	0.041