运动训练时间和患者的治疗参与性对脑卒中患者运动功能预后的影响

Inflnence of the training time of each exercise training session and patients＇ participation on the functional prognosis in stroke patients

目的探讨运动训练时间和患者的治疗参与性对脑卒中患者运动功能预后的影响。方法将60例脑卒中患者随机分为常规训练组和强化训练组，每组30例，2组患者均接受运动训练，但常规训练组患者每次运动训练时间为30～45min，强化训练组患者每次运动训练时间为45～60min。所有患者在入院时和治疗4周后进行功能独立性评定量表（FIM）中的运动功能评定，同时每次运动训练时通过Pittsburgh康复参与量表（PRPS）记录患者的治疗参与情况。结果2组患者治疗前FIM运动功能评分差异无统计学意义（P〉0．05），但治疗后强化训练组患者的FIM运动功能评分明显高于常规训练组患者，差异有统计学意义（P〈0．05），强化训练组治疗前、后FIM运动功能评分改变值明显高于常规训练组（P〈0．01），而且常规训练组和强化训练组患者PRPS评分均与治疗前、后FIM运动功能评分的改变值明显相关（分别为r=0．787，P〈0．01和r=0．573，P〈0．05）。结论运动训练时间能对脑卒中患者的近期运动功能的改善产生影响，患者的主动参与性亦能明显影响其运动功能预后。

Objective To observe the influence of training time of each exercise training session and patients＇ participation on the functional prognosis in stroke patients. Methods Sixty stroke patients were randomly divided into a conventional rehabilitation group and an intensive rehabilitation group,with 30 patients in each group. The patients in both groups were administered with exercise training. The training time of the conventional rehabilita- tion group was 30 -45 min/d, while that of the intensive rehabilitation group was 45 -60 min/d. The motor function of Function Independence Measure （FIM） was used to assess motor comprehensive function before and after 4 weeks of training. The patients＇ participation was evaluated through the Pittsburgh Rehabilitation Participation Scale （PRPS） after every session of motor training. Results There was no significant difference between the two groups in terms of FIM motor function scores before therapy. But FIM motor function scores of the intensive rehabilitation group were significantly higher than that of the conventional rehabilitation group after training （ P 〈 0.05 ） , and the gain of FIM motor function scores after 4 weeks of training in the intensive rehabilitation group were significantly higher than that in the conventional rehabilitation group （P 〈0.01 ）. And the scores of PRPS in the conventional rehabilitation group （ r = 0. 787, P 〈 0.01 ） and the intensive rehabilitation group （ r = 0. 573, P 〈 0.05 ） were significantly related with gains of FIM motor function scores. Conclusion The training time of each session of exercise training can affect the improvement of immediate motor function of stroke patients. The active participation of patients in rehabilitation also affect significantly the patients＇ functional prognosis.