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【論文摘要】The Availability of Weight Bearing Training on Spontaneous Intracerebral Hemorrhage Combined Cognitive Impairment: A Case Report

【論文摘要】承重訓練對認知受損的自發性腦內出血個案之可用性:個案報告

摘要


Background and Purpose: As the progress of cognitive impairment, the ability of activity of daily living will decrease. It is possible to interfere with language and produce emotional problems. A patient with cognitive impairment occurred cerebrovascular accident will significantly interfere with rehabilitation training. Clinically, physical therapy applies weight bearing training to facilitate muscle firing and relaxation. The patient can be positioned passively to achieve the training. The purpose of this case report was to investigate the availability of weight bearing training in post intracerebral hemorrhage (ICH) patient with cognitive impairment. Methods: The case was a 73-year-old female with right hemiplegia, dysphagia, and aphasia. She was able to eat and walk independently before this episode. She cannot communicate with others due to aphasia and cognitive impairment. The weight bearing training began at six weeks post onset. The intervention was weight bearing training in different positions, including side-sitting, all four, prone on elbows, and prone on hands. Each position was maintained at least 1 min and up to 5 min. Each training session was 15 min. The position used in training would depend on patient's ability, and it would gradually change as the patient progressed. Results: The case was ICH in the temporal-occipital region and ICH was removed. The case received nine training sessions. Before intervention, Brunnstrom's stage was IV in the right upper extremity and III in the right lower extremity. Balance was fair in static sitting and poor in dynamic sitting. Transfer needed maximal assistance. The legs of the patient were curled up during transfer. After intervention, Brunnstrom's stage was IV in the right upper extremity and IV in the right lower extremity. Balance was good in static sitting and fair in dynamic sitting. Transfer needed minimal assistance. The feet of the patient slight touched the floor during transfer. Conclusion: It is available to apply weight bearing training in patients with aphasia and patients hard to active participation. Clinical Relevance: Clinically, it is hard to instruct patients with aphasia and cognitive impairment in exercise and movement control. Patient positioning can facilitate muscle activation in weight bearing position and muscle relaxation after training.

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