早期康复治疗对脑卒中偏瘫患者肢体功能及日常生活能力的影响

目的探讨早期康复治疗对急性脑卒中偏瘫患者上下肢功能及日常生活能力的影响，并观察脑卒中偏瘫患者上下肢运动功能的恢复程度有无差别。方法选择急性脑卒中偏瘫患者96例，随机分为康复组和对照组(每组48例)。用前瞻性研究方法对两组进行比较分析。康复组在临床药物治疗的同时进行正规的康复训练，对照组给予临床药物治疗及未经指导的自我锻炼。分别于入选治疗前24h及治疗后6-8周进行测评。运动功能采用Fugl-Meyer运动功能积分法(FMA)测评，日常生活能力用Barthd指数评分。结果经6-8周治疗后，Barthel指数及FMA评分均有一定程度的改善，但其改善幅度康复组明显优于对照组(P＜0.01)。康复组FMA平均值转化为运动最大程度百分比，治疗前后下肢均较上肢为高，但治疗后FMA的提高程度上下肢没有显著性差异(P＞0.05)。结论急性脑卒中偏瘫患者进行早期康复治疗，能明显改善肢体运动功能、提高日常生活能力。从残损水平分析，经过康复治疗后，脑卒中偏瘫患者上下肢运动障碍的恢复程度在病后2个月内是相同的。

Effectsof early rehabilitation on motor function of upper and lower extremities and activities of daily,living in patients with hemiplegia after stroke

Objective: To study the effect of early rehabilitation on motor function of upper and lower extremities and activities of daily living(ADL) in patients with hemiplegia after stroke; and to observe whether motor function recovery of upper and lower extremities is different. Method: 96 patients were randomly divided into two groups, rehabilitation group (48 cases) and control group(48 cases). Prospective method was used in this study. Patients in the rehabilitation group were given clinical treatment and regular rehabilitation training, while those in control group were given clinical treatment and unguided self- training. The evaluation was done in pre- treatment and post- treatment(6- 8 weeks) respectively.Motor function was assessed in Fugl-Meyer assessment(FMA), ADL assessed in Barthel Index. Result: The motor scores (measured by FMA) and ADL scores (measured by Barthel index) in the two groups were improved after 6-8 weeks treatment, but there was a significant difference between the two groups, the scores in the rehabilitation group were obviously superior to those in the control group (P ＜ 0.01 ). The mean of the Fugl-Meyer Scale (transferred to percentage of maximal motor scores) of the lower extremities was higher than that of the upper extremities pre-and post-treatment (P＜0.01). However, the improvement degree of FMA scores between upper and lower extremity had no statistical difference (P＞0.05). Conclusion:Early rehabilitation training of the patients with stroke hemiplegia may obviously improve motor function of the limbs and raise ADL scores. However, the degree of improvement in upper and lower extremity is similar in the first two months after early training.