早期康复治疗对脑卒中偏瘫患者肢体功能及日常生活能力的影响

Effects of early rehabilitation on motor function of upper and lower extremities and activities of daily living in patients with hemiplegia after stroke

目的探讨早期康复治疗对急性脑卒中偏瘫患者上下肢功能恢复及日常生活能力的影响。方法选择急性脑卒中偏瘫患者76例，随机分为康复组和对照组（每组38例）。用前瞻性研究方法对两组进行比较分析。康复组在临床药物治疗的同时进行正规的康复训练，对照组给予临床药物治疗及未经指导的自我锻炼。分别于入选治疗前24h及治疗后6—8周进行测评。运动功能采用Fugl—Meyer运动功能积分法（FMA）测评，日常生活能力用Barthel指数评分。结果经6—8周治疗后，Barthel指数及FMA评分均有一定程度的改善，但康复组明显优于对照组（P〈0.01）。康复组治疗后FMA的提高程度上下肢差异无统计学意义。结论急性脑卒中偏瘫患者进行早期康复治疗能明显改善肢体运动功能、提高日常生活能力。

Objective To study the effect of early rehabilitation on motor function of upper and lower extremities and activities of daily living（ADL） in patients with hemiplegia after stroke. Methods 76 patients were randomly divided into two groups, rehabilitation group （38 cases） and control group（38 cases）. Patients in the rehabilitation group were given clinical treatment and regular rehabilitation training, while those in control group were given clinical treatment and unguided self-training. The evaluation was done in pre-treatment and post-treatment （6- 8weeks） respectively. Motor function was assessed with Fugl-Meyer assessment（FMA） ,ADL assessed with Barthel Index. Result The motor scores（ measured by FMA） and ADL scores （measured by Barthel index） in the two groups were improved after 6-8weeks treatment, but there was a significant difference between the two groups, the scores in the rehabilitation group were obviously superior to those in the control group（ P 〈 0.01 ）. The improvement degree of FMA scores between upper and lower extremity had no statistical difference. Conclusion Early rehabilitation training of the patients with stroke hemiplegia may obviously improve motor function of the limbs and raise ADL scores.