不同康复治疗计划对脑卒中患者功能恢复的影响

目的　观察急性脑卒中患者早期系统康复治疗的有效性 ,探讨恢复期不同康复治疗计划对功能恢复的影响。方法　将 45例发病在 2周内的脑卒中患者随机分为康复组 (2 3例 )和对照组 (2 2例 ) ,康复组又分为康复A组 1 1例 (住院系统康复治疗 1 2周 )和康复B组 1 2例 (住院系统康复治疗 4周后出院由治疗师上门指导家庭康复训练 8周 )。采用Fugl Meyer法、Barthel指数法于治疗前及治疗 4周和 1 2周后评定各组患者的运动功能和日常活动能力。结果　治疗前各组Fugl Meyer及Barthel积分相近 ,差异均无显著性意义(P >0 .0 5) ;治疗 4周和 1 2周后 ,康复组Fugl Meyer及Barthel积分均明显高于对照组 ,差异有非常显著性意义 (P <0 .0 1 ) ;治疗前和治疗 4周后康复A组和B组的Fugl Meyer及Barthel积分差异没有显著性意义 (P >0 .0 5) ;治疗 1 2周后康复A组Fugl Meyer值明显高于康复B组 ,差异有非常显著性意义 (P <0 .0 1 ) ,而两组Barthel积分差异没有显著性意义 (P >0 .0 5)。结论　早期系统康复治疗可以有效地提高患者的运动功能和改善ADL能力 ,恢复期继续给予至少 8周家庭指导康复训练则更有利于提高患者的独立生活能力 ,并可减少医疗费用、缩短住院时间及利用可用的资源 ,促进患者的全面康复

Effects of different rehabilitation programs on the functional outcomes in patients with stroke

Objective To study effect of early systemic rehabilitation treatment and different rehabilitation programs on the functional outcomes in patients with stroke. Methods Forty five cases of acute stroke were divided into rehabilitation group ( n =23) and control group ( n =22). The rehabilitation group was further divided into two subgroups: subgroup A ( n =11) in which the patients received intensive rehabilitation intervention for 12 weeks, and subgroup B ( n =12), in which the patients got intensive rehabilitation for 4 weeks, followed by home rehabilitation training for another 8 weeks. Fugl Meyer scale and Barthel index were used to assess motor function and ADL at pre therapy and 4 and 12 weeks post therapy, respectively. Results The scores of Fugl Meyer and Barthel index in both rehabilitation and control groups were similar at pre therapy stage ( P >0.05), but the patients in the rehabilitation group demonstrated much higher scores in Fugl Meyer and Barthel index than those in the control group at the end of 4 and 12 weeks after rehabilitation therapy( P <0.01); both rehabilitation subgroups showed the similar scores pre and 4 weeks post therapy; the scores of Fugl Meyer in the rehabilitation subgroup A were obviously superior to that in the subgroup B, but the integral Barthel scores in both rehabilitation subgroups had no significant difference ( P >0.05) 12 weeks after the therapy. Conclusion Early intensive rehabilitation therapy can effectively improve the motor function and ADL of stroke patients; the continuing home rehabilitation program for at least 8 weeks is helpful for improving the patient's functional independence, increasing the cost effectiveness, and shortening the length of stay of stroke patients.