早期康复治疗对急性脑卒中运动功能恢复的影响

The effects of early rehabilitation on motor function in acute stroke patients

探讨早期康复治疗对急性脑卒中偏瘫患者发病1个月时运动功能恢复的影响。方法:将57例脑卒中患者随机分为康复组和对照组。于发病后7—23天,对康复组30例脑卒中患者,用以Bobath为主的运动疗法进行康复训练,至病后1个月时结束,对照组27例脑卒中患者不接受康复训练。两组药物治疗基本相同。用Fugl-Meyer运动功能评定法(FMA)评定患者的运动功能;用脑卒中患者临床神经功能缺损程度评分标准(ND)评定患者的病情严重程度。结果:康复治疗前后康复组与对照组比较肌张力差异均无显著性(P>0.05);康复治疗前、后ND的差值康复组与对照组比较差异有显著性(P=0.01),康复治疗后,康复组神经功能缺损程度明显减轻;康复治疗前、后FMA评分的差值,康复组与对照组比较,上肢差异有显著性(P<0.05),下肢差异无显著性(P>0.05)。结论:脑卒中发病1个月内,早期短期的康复治疗,可降低临床神经功能缺损积分,提高患者的上肢运动功能。

Objective:To investigate the effects of early rehabilitation on motor function in acute stroke patients within 1 month after stroke.Method:57 acute stroke patients were randomly divided into early rehabilitation group (R, 30 cases) and control group (C, 27 cases). The patients in R group received rehabilitation intervention from 7-23 days to 1 month after stroke. The patients in both groups received the similar pharmological treatment,the demography information was similar.Neurological deficit evaluation(ND) and Fugl-Meyer Motor Assessment Scale(FMA) were used in assessment.Result:The scores of ND,FMA and the status of the muscle tone in both groups were similar at pre-therapy stage(P>0.05).In post-therapy stage, there were no significant difference between R and C groups in muscle tone. The different scores between post and pre-therapy stage of ND and FMA in upper limb were significant(P<0.05). There were no significant difference between R and C groups in the different scores between post and pre-therapy stage of FMA in lower limb(P>0.05). Conclusion:Early,short period rehabilitation intervention can decrease stroke patients neurological deficits scores and improve upper limb motor function within 1 month after stroke.