Early Rehabilitation of Acute Stroke Patients with Hemiplegia and Effects of regional Cerebral Blood Flow (rCBF) of the Patients with Cerebral Infarction by Early Rehabiiitation

Objectives: To investigate whether early rchabilitation could improve obviously clinical prognosis of acute stroke patients. The mechanism of early rehabilitation that could improve brain function was preliminarily studied. Methods: 240 patients with acute hemiplegia were randomly divided into control group (120 cases) and rehabilitation group (120 cases). The control group received general treatment and the latter received early rehabilitation (Bobath methods) besides general treatment. At pre-rehabilitation and the end of 1,2,3,4,5,6 month at post-rehabilitation, the neurological deficit was assessed with modified Edinbcrg-Scandinavian stroke scale (MESSS); the motor function of the hemiplegic limbs were assessed with modified Fugl-meyer motor scale (FM);the ADL were assessed with modified Barthel Index (MBI), and the general secondary complications of both groups were also evaluated. Moreover, rCBF of 72 cases of acute cerebral infarction with hemiplegia (34 in control group, 38 in rehabilitation group) was earned out by SPECT imaging at pre-rehabilitation and at the end of I month at post - rehabilitation.Results and Discussion: Compared with those of control group, at the end of 1,2,3,4,5,6 month at post - rehabilitation, the scores of MESSS were more obviously decreased (p＜0.05 and p＜0.01); the scores of MBI and FM were more significantly increased (p＜0.05 and p＜0.01); and morbidity of secondary complications was more significantly decreased (p＜0.05 and p＜0.01). Compared with those of pre-rehabilitation in rehabilitation group, both the decrease of MESS scores and the increase of FM, MBI scores were more obvious (p＜0.01) at the end of 1,2,3 month of post-rehabilitation; however, compared with that of the end of 3 month at post-rehabilitation, at the end of 4,5,6 month of post-rehabilitation in rehabilitation group. Both the decrease of MESSS scores and the increase of FM scores hadn′t statistical significance (p＞0.05). but scores of MBt were obviously increased (p＜0.05). There were positive correlation between FM scores at pretreatmcnt and at the end of 3 month. There were negative correlation between MESSS scores at pretreatment and at the end of 1,2,3 month at post-treatment and MBI scores at the end of 3 month. The rCBF imaging was more obviously promoted at the end of 1 month of post-rehabilitation in rehabilitation group (p＜0.05).Conclusions: Early rehabilitation can not only obviously reduce the neurological deficit, general secondary complications and disabilities but clearly improvc the motor function of hemiplegic limbs, activities of daily living, ischcmic rCBF and prognosis in the acute stroke patients. The mechanisms that early rehabilitation can improve brain function of stroke patients are closely related to brain plasticity and functional reorganization.