基于ICF框架的卒中后肘关节痉挛多维度康复：机制与临床干预

Multidimensional Rehabilitation of Post-Stroke Elbow Spasticity Based on the ICF Framework: Mechanisms and Clinical Interventions

摘要: 背景：卒中后肘关节痉挛在病理机制和疗法上进展显著，但多基于传统康复模式，缺乏《国际功能、残疾和健康分类》(ICF)框架的全面应用和整合。目的：基于ICF框架，系统分析卒中后肘关节痉挛的功能障碍，并探讨其康复干预策略的临床转化价值。方法：从身体结构与功能、活动与参与及环境因素三个维度，综述卒中后肘关节痉挛的病理生理机制；结合近5年国内外临床研究证据，总结不同干预措施的应用效果。结果：ICF框架能全面评估痉挛患者的功能障碍，多维度联合干预可显著缓解痉挛状态，并增强患者社会参与，优化康复结局。结论：基于ICF框架的康复干预弥补了传统康复模式的不足，未来需加强多学科协作、中医适宜技术应用及个体化方案研究。

Abstract: Background: Significant progress has been made in the pathological mechanism and therapy of post-stroke elbow spasticity, but it is based on traditional rehabilitation models, failing to incorporate or comprehensively apply the framework of the International Classification of Functioning, Disability and Health (ICF). Objective: Based on the ICF, systematically analyze the functional impairments of post-stroke elbow spasticity and explore the clinical transformation value of its rehabilitation intervention strategies. Methods: This review comprehensively examines the pathophysiological mechanisms of post-stroke elbow spasticity through three dimensions of the ICF: body structure and function, activity and participation, and environmental factors. By synthesizing clinical evidence from both domestic and international studies published in the last five years, the review systematically evaluates the therapeutic efficacy of various intervention approaches. Results: The ICF enables a comprehensive assessment of functional impairments in patients. Multidimensional combined interventions can significantly alleviate spasticity, enhance social participation, and optimize rehabilitation outcomes. Conclusion: The intervention based on the ICF has made up for the shortcomings of the traditional models. It is necessary to strengthen multidisciplinary collaboration, apply appropriate techniques of traditional Chinese medicine, and conduct research on individualised programmes in the future.