早期精准化运动在急性缺血性脑卒中偏瘫患者运动康复中的作用

Effect of early precision exercise on motor rehabilitation of acute ischemic stroke and hemiplegia

目的探讨早期精准化运动在急性缺血性脑卒中偏瘫患者运动康复中的应用效果。方法纳入56例2020-07-2022-06张家口市第一医院神经内科收治的急性缺血性脑卒中偏瘫患者,采用随机数字表法分为对照组和试验组各28例。对照组采取早期常规运动干预措施,试验组采用早期精准化运动干预,2组均连续干预3个月,随访6个月。比较2组干预前、随访6个月时运动功能、生活能力,干预前、干预后3个月、随访6个月时神经功能、希望水平,干预前、干预后3个月的炎症指标及随访期间的并发症。结果与干预前比较,随访6个月时2组患者Fugl-Meyer运动功能评分(FMA)、功能性步行量表(FAC)、Berg平衡量表(BBS)、改良Barthel指数评分升高,试验组高于对照组(P<0.05)。与干预前比较,干预后3个月、随访6个月时2组患者美国国立卫生研究院卒中量表(NIHSS)评分呈降低趋势,试验组干预后3个月、随访6个月时NIHSS评分低于对照组(P<0.05);2组患者Herth希望量表(HHI)评分呈升高趋势,试验组干预后3个月、随访6个月时HHI评分高于对照组(P<0.05)。与干预前比较,干预后3个月2组患者血清脂蛋白相关磷脂酸A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)水平降低,试验组低于对照组(P<0.05);2组患者血清血管生成素-1(Ang-1)水平升高,试验组高于对照组(P<0.05)。随访期间试验组和对照组均未出现明显并发症。结论早期精准化运动可减轻急性缺血性脑卒中偏瘫患者炎症反应,改善运动功能及神经功能,提高患者生活能力和希望水平,具有良好的安全性。

Objective To investigate the application effect of early precision exercise on motor rehabilita⁃tion of patients with acute ischemic stroke and hemiplegia.Methods Fifty-six patients with acute ischemic stroke hemiplegia admitted to the Neurology Department of Zhangjiakou First Hospital from July 2020 to June 2022 were randomly divided into the control group and the experimental group with 28 cases each.The control group received early routine exercise intervention,while the experimental group received early precision exercise intervention.Both groups received continuous intervention for 3 months and were followed up for 6 months.The motor function and life ability of the two groups before intervention and after 6 months of following-up,as well as the neurological function and level of hope before and 3 months after intervention,and 6 months after following-up,as well as the inflammatory indicators before and 3 months after intervention,and the comorbidities during following-up were compared.Results Compared with before intervention,after 6 months of following-up,the scores of Fugl-Meyer assessment(FMA),functional ambulation category(FAC),Berg balance scale(BBS),and modified Barthel index(MBI)increased in both groups,and the experimental group was higher than the control group(P<0.05).Compared with before intervention,after 3 months of intervention and 6 months of following-up,the score of National Institutes of Health stroke scale(NIHSS)of the two groups showed a decreasing trend,and the score of NIHSS of the experimental group after 3 months of intervention and 6 months of following-up were lower than those of the control group(P<0.05).The score of Herth hope scale(HHI)of the two groups showed an upward trend,and the score of HHI of the experimental group after 3 months of intervention and 6 months of following-up were higher than those of the control group(P<0.05).Compared with that before intervention,after 3 months of in⁃tervention,the levels of serum lipoprotein related phosphatidic acid A2(Lp-PLA2)and high-sensitivity C-reactive protein(hs-CRP)in the two groups decreased,and the experimental group was lower than the control group(P<0.05);the levels of serum angiopoietin-1(Ang-1)increased in both groups,and the experimental group was higher than the control group(P<0.05).During the following-up period,there were no significant complications in both the experimental group and the control group.Conclusion Early precision movement could alleviate inflamma⁃tion in patients with acute ischemic stroke and hemiplegia,improve motor function and neurological function,and improve the patients life ability and level of hope,with higher safety.