社区脑卒中偏瘫患者早期物理治疗与功能变化的观察

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。

Effects of Early Rehabilitation on Limb Function Recovery of Stroke Patients with Hemiplegia in Community

Objective To investigate the effects of early rehabilitation on limb function and daily life activity ability recovery of stroke patients with hemiplegia in community.Methods Seventy two primary stroke inpatients(54 cases of cerebral embolism and 18 cases of cerebral hemorrhage) confirmed by CT or MRI were randomly divided into rehabilitation group and control group,there was no statistical difference in age,gender and illness aspects between the two groups.Base on the routine medicine treatment,the rehabilitation group received additional rehabilitation therapy including exercise therapy(Bobath training) and occupational therapy(improving cognitive ability and daily life activities).Fugl-Meyer scale and Modified Barthel Index were used to assess the balance function of limbs and daily life activity of patients with hemiplegia after stroke.Results The curative effect of the rehabilitation group was obvious better than that of the control group,especially in the early recovery stage(1 to 3 months after stoke) and intermediate stage(3 to 6 months after stoke),and the difference was statistically significant(P<0.05).Conclusion In the acute stage of stoke,when the condition is steady,the early functional rehabilitation can be carried out.It will prompt muscle spasms or irregular movement mode to change to the separatist movement(spasm weakened obviously) and coordinated movements(spasm disappear),and decrease the neural function defect,improve the daily living skills and independent ability,reduce the complications,improve the quality of life,and help them to return to the society.