早期康复对脑卒中患者功能恢复的影响

Functional prognosis of patient with acute stroke with early rehabilitation

目的 :探讨早期康复对急性脑卒中患者功能预后的影响。方法 :在患者生命体征稳定 ,神经病学体征不再进展后 48小时选择 1 0 9例急性脑卒中患者 ,随机分为早期康复组和对照组。其中早期康复组 58例 ,采用Bobath法和运动再学习法相结合的方法进行训练 ;对照组 51例 ,仅进行一次性康复指导。采用临床神经功能缺陷程度评分、简式Fugl Meyer运动评分 (FMA)和改良巴氏指数 (MBI)在治疗前后进行康复评价。 结果 :临床神经功能缺陷程度评分、上下肢FMA和MBI入选时两组无显著差异 (P >0 .0 5) ,出院时两组均较入选时明显改善 (P <0 .0 1 ) ,早期康复组较对照组改善程度更大 (P <0 .0 5)。结论 :早期康复可促进功能恢复 。

Objective:To investigate the effect on the functional prognosis of acute stroke patients with early rehabilitation.Method:109 patients were randomly divided into two groups.Early rehabilitation group consisted of 58 patients and were treated with Bobath′s and motor relearning programme method. Control group had 51 patients whom were instructed to rehabilitate only once.The two groups were assessed by the clinical neural function defect assessment set,concise Fugl Meyer assessment(FMA)and modified Barthel index(MBI).Result:The scores of the clinical neural function defect assessment set,FMA,MBI demonstrated:there were no different between two groups before treatment( P >0.05),the scores improved significantly( P <0.01)between pre training and post training in the two groups,but the degree of improvement in the early rehabilitation group was significantly higher than that of the control group.Conclusion:Early rehabilitation could facilitate the function recovery,and gain a good functional prognosis in stroke patients. Author′s address Dept. of Physical Medicine and Rehabilitation of the First Affiliated Hospital Sun Yat sen University of Medical Sciences,Guangzhou,510080