Analysis and Reflection on Hospital-based Rehabilitation and Postdischarge Community-based Intelligent Cloud Rehabilitation Mode for Spinocerebellar Ataxia Type 2 in a Child

doi:10.12114/j.issn.1007-9572.2020.00.609

Abstract

Abstract: Background　Childhood onset of spinocerebellar ataxia type 2（SCA-2）is very rare.Currently，in addition to symptomatic drug treatment，active rehabilitation treatment is the key to possibly maintaining the self-care ability and improving quality of life in SCA-2 patients.Objective　To analyze the hospital-based rehabilitation and postdischarge community-based intelligent cloud rehabilitation for a child with SCA-2，to provide a reference for the delivery of rehabilitation treatment for such patients.Methods　Retrospective analysis was conducted on the clinical data，hospital-based rehabilitation treatment strategies and effect of postdischarge community-based intelligent cloud rehabilitation treatment for a child with SCA-2 who was admitted to the Rehabilitation Center of Changzhou Dean Hospital in 2018.Results　After 30 days of in-hospital systematic rehabilitation treatment，the child showed significant improvement in coordination，balance，feeding ability and other functions，indicating that he could take care of himself basically.After 1 year of postdischarge community-based intelligent cloud rehabilitation treatment，the child’s memory and attention showed a declining trend，but there was no significant decline in his coordination，balance，transfer，feeding and walking abilities，and he was able to complete the indoor 10-meter walk，take care of himself basically，and manage to attend school normally.And family and social supports for him are continuing to improve.Conclusion　This pediatric case of SCA-2 presented significant improvement in coordination，balance，eating and walking abilities and could basically take care of himself after in-hospital systematic rehabilitation treatment delivered based on precise assessment，and postdischarge community-based intelligent cloud rehabilitation treatment.Postdischarge community-based intelligent cloud rehabilitation mode may be as a new mode of continuing rehabilitation by community physicians to deliver home-based rehabilitation trainings and to deliver rehabilitation treatment for patients with lifelong diseases.

Key words: Spinocerebellar ataxias, Child, Rehabilitation, Treatment outcome, Postdischarge community-based intelligent cloud rehabilitation mode, Case management

摘要： 背景　脊髓小脑共济失调2型（SCA-2）儿童期发病者十分罕见，目前除药物对症治疗外，积极进行康复治疗是尽可能维持患者日常生活自理能力、提高患者生活质量的关键。目的　分析1例SCA-2患儿康复治疗过程及其社区智慧化延续性云康复模式，为SCA-2的康复治疗提供参考。方法　回顾性分析常州市德安医院康复中心2018年收治的1例SCA-2患儿的临床资料、康复治疗策略及社区智慧化延续性云康复治疗效果。结果　患儿经院内系统康复治疗30 d后协调、平衡、进食、步行能力等明显改善，日常生活基本自理；经社区智慧化延续性云康复治疗1年后，患儿记忆力、注意力出现下降趋势，但协调、平衡、转移、进食、步行能力无明显退步，且能完成室内10 m步行，日常生活基本自理，坚持日常校园生活，家庭支持和社会服务保障在持续完善中。结论　本例患儿经院内精准化评估、院内系统康复治疗、社区智慧化延续性云康复治疗后协调、平衡、进食、步行能力等明显改善，日常生活基本自理；社区智慧化延续性云康复模式可能是社区医师开展家庭康复训练及终身性疾病患者康复治疗的新模式。

关键词: 脊髓小脑共济失调, 儿童, 康复, 治疗结果, 社区智慧化延续性云康复模式, 病例管理

QIAN Xue,ZHUANG Ren,HE Jun, et al. Analysis and Reflection on Hospital-based Rehabilitation and Postdischarge Community-based Intelligent Cloud Rehabilitation Mode for Spinocerebellar Ataxia Type 2 in a Child　[J]. Chinese General Practice, 2021, 24(21): 2717-2720. DOI: 10.12114/j.issn.1007-9572.2020.00.609.
钱雪,庄任,何俊等. 脊髓小脑共济失调2型患儿的康复治疗及社区智慧化延续性云康复模式的分析与思考[J]. 中国全科医学, 2021, 24(21): 2717-2720. DOI: 10.12114/j.issn.1007-9572.2020.00.609.

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