早期康复训练对脑卒中偏瘫患者前3个月功能恢复的可能性

Possibility of functional recover with early rehabilitation training during the first 3 months in hemiplegic patients with stroke

目的:探讨利用综合的康复训练方法对脑卒中偏瘫患者发病后1～3个月的运动功能和日常生活活动能力的影响。方法:64例符合入选标准的上海地区脑卒中偏瘫患者随机分成治疗组(40例)和对照组(24例),两组均按神经内科常规进行药物治疗,治疗组另给予综合利用Bobath、神经促通技术等的手法训练、作业治疗训练及电刺激疗法等,每例患者进入课题时、1个月后和3个月后分别评价1次Fugl-Mayer(FMA)运动功能和ADL能力(BI值),进行对照研究。结果:FMA:治疗组分别为(21±16),(47±22),(70±23)分,对照组为(20±19),(28±21),(36±23)分。BI值:治疗组分别为(29±23),(66±20),(85±17)分,对照组为(28±25),(41±24),(55±24)分。两组前后比较差异均有显著性意义;治疗组前一阶段和后一阶段运动功能恢复均显著优于对照组(P<0.001);ADL能力后一阶段两组恢复程度无差异(P>0.05),前一阶段治疗组ADL恢复优于对照组(P<0.001)。结论:早期综合利用各种治疗方法康复训练对脑卒中偏瘫患者前3个月的运动功能和日常生活活动能力具良好的促进作用。

AIM: To explore the effect of comprehensive rehabilitation training on motor function and activities of daily living (ADL) in hemiplegic patients 1-3 months after stroke. METHODS: Sixty four hemiplegic patients with stoke, who met with the selecting criterion, were randomly divided into two groups: the study group(n=40)and the control group (n=24). Patients in both groups were given routine drug treatment, besides, patients in the study group were treated with manual training, occupational therapy training and electric stimulation therapy by using Bobath and proprioceptive neuromuscular facilitation(PNF) technique.The Fugl Mayer(FMA) motor function and ADL Barthel index (BI) of all patients were evaluated before treatment, one month and 3 months after treatment for clinical control study. RESULTS: The FMA scores in the study groups were (21±16), (47±22) and (70±23), while those in the control group were (20±19), (28±21) and (36±23). The value of BI in the study group were (29±23), (66 ±20) and (85±17), while those in the control group were (28±25), (41±24) and (55±24).There were significant differences between the two groups. Comparison of the mean of changes: the motor functional recover of the former and latter periods in the study group were significantly better than those in the control group (P< 0.001). There were no differences in ADL BI of the latter period between the two groups(P >0.05), while the recover of ADL of the former period in the study group was significantly better than that in the control group(P< 0.001). CONCLUSION:Early rehabilitation training can improve the motor function and ADL and reduce the dysfunction significantly in hemiplegic patients with stroke.