中風病患的擺位－文獻回顧

Positioning for Hemiplegic Patients: A Review of Articles

康淑美(Shwu-Meei Kang)

《職能治療學會雜誌》 4卷 (1986/11) Pp. 21-28

https://doi.org/10.6594/JTOTA.1986.04.03

摘要

關於中風病人的臥床姿勢，每本書的說法各有不同，甚至完全相反，筆者因此蒐集了二十篇從1968年到1985年的著作，加以整理比較。
筆者發現早期的作者主張仰躺最好，臥在患側應儘量避免，現在多數作者則認爲仰躺最危險，有許多不良的影響，而臥在健側最安全、最無副作用。早期作者都企圖以副木或類似之外物來控制不正常張力對肢體末端的影響，近來之作者發現這些處置效果不彰，不如以姿勢控制－從近端到遠端都擺在反痙攣的姿勢上，自然末端之變形不會出現。
八十年代之作者在臥姿上亦有不同的看法，有的主張中位姿勢，有的主張完全相對於痙攣姿勢的極端相反姿勢，有的講究功能形態姿勢。
臨床上各個病人之病情、發展階段、個性及客觀環境不同，治療團隊人員宜通盤考慮給病人一個最合適的臥姿建議及治療計劃。

並列摘要

For the purpose of resolving the disagreements among articles about proper positioning for hemiplegic patients, the articles published from 1968 to 1985 were reviewed. The earlier authors favor ”supine position”, while the recent authors prefer ”side-lying”. The earlier authors use splint to control abnormal muscle tone or prevent deformity of distal parts of the limbs, while the later authors consider that good control of total posture would release the distal muscle tone without the splints or other devices because those would increase abnormal muscle tone. Under the influence of Bobath concept about anti-spastic patterns, some of the authors of the 80's suggest ”neutral positioning”, and the other ”total spastic inhibition pattern” as the proper positioning for hemiplegics. Clinically, the hemiplegic patients have different degree of severity and recovery stage, all team workers should carefully consider the different opinions about positioning and find the proper positioning to approach their patients.

並列關鍵字

stroke rehabilitation ； positioning