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目的了解脑卒中偏瘫患者早期进行康复治疗后,患侧肢体运动功能及日常生活活动能力恢复情况。方法选择住院患者中首次发病脑卒中患者72例(脑血栓患者54例,脑出血患者18例),都经过脑CT、MRI检查证实,诊断明确。采用随机化原则分为康复组和对照组,两组患者在年龄、性别、病情状况等方面差异无统计学意义,具有可比性。两组均接受常规内科治疗,康复组在内科治疗基础上进行康复治疗,使用运动疗法(Bobath训练)及作业疗法(改善认知及日常生活活动能力),康复组采用Fugl-meyer评定量表及巴氏指数评定脑卒中偏瘫住院患者康复治疗前后时的肢体平衡功能及日常生活功能状况。结果脑卒中患者进行早期康复锻炼治疗较单纯内科治疗功能状况恢复好,一般脑卒中发病后1～3个月(恢复早期)或发病后后3～6个月(恢复中期),这两个时期是康复治疗和各种功能恢复最重要的时期,差异有统计学意义(P<0.05)。结论在脑卒中患者急性期,病情平稳后,早期进行功能康复治疗,有助于促使肌痉挛或异常运动模式向分离运动(痉挛明显减弱)和协调运动(痉挛消失)发展,使神经功能缺损能明显减少,提高日后的日常生活能力和功能独立能力,减少并发症,提高生活质量,帮助其重返社会。
Objective To understand the rehabilitation of stroke patients with hemiplegia after early rehabilitation, the affected limb motor function and daily living activity recovery. Methods Seventy-two stroke patients (54 patients with cerebral thrombosis and 18 patients with cerebral hemorrhage) were included in the study. All patients were confirmed by CT and MRI. The diagnosis was clear. The principle of randomization was divided into rehabilitation group and control group. There was no significant difference between the two groups in terms of age, gender, condition and so on, which was comparable. Both groups received routine medical treatment. The rehabilitation group received rehabilitation therapy based on medical treatment, using exercise therapy (Bobath training) and homework therapy (improving cognition and activities of daily living). The rehabilitation group was assessed using the Fugl-meyer scale, Pasteur index assessment of stroke patients with hemiplegia rehabilitation of patients before and after limbs balance function and daily life function status. Results Compared with the medical treatment alone, the early rehabilitation exercise in patients with stroke recovered well, generally 1 to 3 months after the onset of stroke (early recovery) or 3 to 6 months after the onset (middle recovery), and these two periods Is the most important period of rehabilitation and various functional recovery, the difference was statistically significant (P <0.05). Conclusions In the acute stage of stroke patients, after the disease is stable, early functional rehabilitation therapy may help to promote the development of the spasticity or abnormal exercise mode to isolated movement (obviously decreased spasticity) and coordinated movement (spasticity disappear) Significantly reduce and improve the ability of daily living and functional independence in the future, reduce complications, improve the quality of life and help them reintegrate into society.