比較中風病人使用彈性繃帶和新型手部輔具執行上肢被動運動的手溫變化

Comparison of Conventional Elastic Bandages and Novel Hand Gloves by Measuring Changes in Stroke Patients' Hand Temperature During Passive Upper Limb Exercises

李美誼(Mei-Yi Lee) ； 曹展毓(Chan-Yu Taso) ； 劉嘉禧(Ka-Hei Lao) ； 陳姝希(Shu-Shi Chen)

《台灣復健醫學雜誌》 45卷1期 (2017/06) Pp. 11-18

https://doi.org/10.6315/2017.45(1)02

摘要

中風病人的患側手以彈性繃帶(彈繃)固定進行復健治療，經常導致手部軟組織的傷害，因而研發新型手部輔具－『悠樂手』。本研究初步探討中風病人的患側手以彈繃及悠樂手固定，執行上肢被動運動的手溫變化。徵召18名中風病人(63.1 ± 13.4歲)，患側手以彈繃或悠樂手固定於信望愛的握把，執行15分鐘的上肢被動運動。以温度記錄器記錄運動前、中及後的手溫。以成對樣本t檢定分析彈繃或悠樂手固定的患側手，與健側手於各時期溫度變化的差異。運動中，以彈繃固定患側手與健側手的最低溫無不同(p=0.07)，但患側手的最高溫低於健側手(30.93°C vs. 31.64 °C, p=0.002)。以悠樂手固定，兩手的最低和最高溫皆無差異(p=0.09; p=0.35)。以彈繃和悠樂手固定的患側手溫變化範圍為-3.29 °C和-1.77 °C(p=0.001)。運動後溫度恢復，以彈繃及悠樂手固定之患側手溫為-1.05 °C和0.25 °C(p=0.01)。中風病人患側手以彈繃比以悠樂手固定於信望愛儀器執行上肢被動運動，手部溫度降幅較大，運動後並無回到起始溫度，所暗藏的風險值得高度關注。

關鍵字

中風(Stroke) ； 運動(Exercise) ； 彈性繃帶(Elastic bandages) ； 悠樂手(Yole Hands) ； 溫度(Temperature)

並列摘要

Elastic bandages are often used to secure stroke patients' affected upper limbs to exercise equipment during physical rehabilitation. However, the application of elastic bandages can cause soft tissue injuries in patients' extremities. Therefore, our research team developed novel medical hand gloves, called ＂Yole Hands,＂ to safely secure stroke patients' affected hands to exercise equipment. This study compared conventional elastic bandages with Yole Hands by measuring changes in stroke patients' hand temperature during passive upper limb exercises. This study recruited 18 stroke patients aged 63.1 ± 13.4 years from a rehabilitation clinic. A thermograph (midi LOGGER GL220, Graphtec) was used to record patients' hand temperature initially, throughout the exercise (15 minutes), and 5 minutes after completing the exercise. Paired t tests were used to compare the differences in hand temperature between patients' affected and unaffected hands during and after exercise and between Yole Hands and elastic bandage usage conditions. When patients used elastic bandages during the exercise, no significant differences were observed in the lowest temperatures between their affected and unaffected hands (p = 0.07). However, a significant difference was observed in the highest temperature between patients' affected and unaffected hands (30.93°C vs. 31.64°C, p = 0.002). When patients used Yole Hands during exercise, no significant differences were observed in either the lowest temperatures (p = 0.09) or highest temperatures (p = 0.35) between their affected and unaffected hands. The average temperature change in patients' affected hands that were secured with elastic bandages was lower than that in hands secured with Yole Hands (approximately -3.29°C vs. -1.77°C, p = 0.001). After completing exercises, the temperature recovery of patients' affected hands was significantly different between elastic bandage and Yole Hands usage conditions (-1.05°C vs. 0.25°C, p = 0.01). During exercise, the temperature of the patients' affected hands was significantly lower under the elastic bandage usage condition than under the Yole Hands usage condition. After completing exercise, the temperatures of the patients' affected hands that were secured with elastic bandages did not return to their initial baselines. Thus, clinicians should be highly concerned about the hidden risks of using elastic bandages to secure stroke patients' affected upper limbs to exercise equipment.

並列關鍵字

Stroke ； Exercise ； Elastic bandages ； Yole Hands ； Temperature

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