事件记录
Dr. 米勒: 中风后如何恢复自信. 这是下一个范围广播.
大家好，今天我和 Dr. Stephen Edgley. He is an associate professor in the department of physical medicine and rehabilitation in the University of Utah. Steve, a patient has had a 中风 and is having difficulty walking. What do they need to do, to be able to get back on their feet again and get around?
如何让中风患者行走
Dr. Edgley: This is an extremely critical point that so many patients, 个月的, 实际上在几年前, 在经历了 中风. The typical 中风 patients are by and large...
Dr. 米勒: Now, we are talking about a 中风 patient where one side of the body, one leg is affected. 我这么想对吗?
Dr. Edgley: 通常.
Dr. 米勒: 通常,好的. 通常不是两者都有，而是在一边.
Dr. Edgley: 所以通常一方比较弱. I'm going to stress how the importance of being as active as possible and this carries huge health consequences. We know that the insistence of heart disease, 糖尿病, major risk factors can actually lead to death is much greater when you're inactive.
Dr. 米勒: Getting back on your feet is important for more than one reason.
步行步态
Dr. Edgley: 是的, also the quality of life reasons being able to [inaudible 00:01:46] the community is also an important factor. We have a lot of research that clearly shows that if a 中风 patient is able to achieve a good speed, 步行速度只有1.每小时8英里, they will most likely an predictably be able to ask us the community, walking in the community rather than just walking and hobbling around the home.
Dr. 米勒: So the need to do the physical therapy is one thing but these patients also have not just weakness sometimes but pain, 患侧痉挛. 是这样吗，史蒂夫?
中风患者的物理治疗
Dr. Edgley: 是的，这是另一个临界点. These patients typically need an intervention by a specialist in rehab to overcome the barriers to achieve better walking speed. Those barriers are typically things like spasticity of muscle tying their leg up, 抑制快走. 比如疼痛和低耐力.
Dr. 米勒: How often would pain occur in someone with a 中风?
Dr. Edgley: Well it depends, pain syndromes are typically exacerbated by the hemiparetic gait. So the gait mechanics being a little all off counter leads patients be more susceptible to common things like joint arthritis. There are some specific pain syndromes that occur as a result of 中风 sometimes.
Dr. 米勒: I would guess that the post-中风 patient who has suffered weakness to the leg is not getting this team approach that the physiatrist supplies, that their recovery is going to be delayed or really impaired.
Dr. Edgley: I see patients that have gone on for years being restricted to the home environment with little intervention and attention to these barriers can often achieve great results even to the extent of a much greater quality of life.
Dr. 米勒: So what are the barriers to maybe walking faster than the 1.每小时8英里. Can they eventually build up to a pace that is faster than that?
Dr. Edgley: 这取决于很多变量. We approach it like this, first try to break down as many barriers to walking speed as possible. 然后让他们进入侵略性的 物理治疗项目. 然后重新评估形势.
Typically if the patient can walk a limited distance at home, we can influence the situation to enable the patient to be somewhat effective at walking in the community by breaking down these barriers in a more specialized and team-oriented therapy approach.
Dr. 米勒: So a patient with this 中风 problem where they can't walk, once they get into therapy are we actually teaching another part of the brain to help take over?
Dr. Edgley: 大发娱乐经常是, 大脑有很大的潜力去做, 适应, 和改变, 甚至在中风数年后. 大发娱乐真正在做的是治疗, 尤其是几个月、几年之后, a 中风 is trying to capitalize on the brain's ability to be plastic and 适应. Teaching them the [inaudible 00:06:23] strategies for faster walking and more functional movement.
Dr. 米勒: 所以，不仅仅是走路? What you pointed out, is that patients after a 中风, who walk, are able to get going. As opposed to those who don't, do better in the long run, live better, and live healthier. It seems like such a simple thing, yet it has remarkable consequences.
Dr. Edgley: 事实上, it is an extremely critical and some people we now consider walking speed to be the fifth vital sign. It's something we measure in our clinic as an objective measure of how they're doing overall and how they're doing physically.
更新日期：2020年7月15日
最初发布日期：2014年8月5日