脑卒中康复运动功能评定量表的临床应用分析

目的：运动脑卒中康复运动功能评定量表（stroke rehabilitation assessment of movement,STREAM）比较脑卒中偏瘫患者患侧上、下肢运动功能损害程度、恢复结果以及不同临床特征偏瘫患者运动功能恢复的差异。方法：用STREAM方法对114例脑卒中偏瘫患者治疗前、后进行评定并进行统计分析。结果：康复治疗前、后STREAM平均上、下肢运动分无明显差异（P＞0．05），平均下肢改变值和恢复效率高于上肢（P＜0．05）。病程≤1个月的脑卒中患者其治疗后的平均STREAM总分、改变值和效率均高于病程＞1个月的患者（P＜0．05）。年轻患者（＜65岁）的平均STREAM改变值和恢复效率均高于年老组（≥65岁）。脑出血患者平均STREAM改变值高于脑梗死患者（P＜0．05）。男、女患者间以及不同偏瘫侧患者间的运动功能恢复结果无明显差异（P＞0．05）。结论：脑卒中偏瘫患者偏瘫侧下肢运动功能恢复的幅度和速度都高于上肢。早期康复的结果和治疗效率要好于延迟康复的患者。年轻患者运动功能恢复的幅度和速度要优于年老患者。故在康复治疗初期，制定训练计划和进行训练时应考虑脑卒中患者偏瘫侧上、下肢恢复的差异以及患者病程、年龄等因素的差异。

Analysis of the clinical application of stroke rehabilitation assessment of movement (STREAM)

Objective To compare the severity of motor impairment and the motor recovery outcome of the upper and lower extremity by using the STREAM in stroke patients, and to measure the difference among the patients with different clinical features, in terms of motor recovery. Methods Motor functiona status of 114 hemiplegic patients were measured by STREAM before and after rehabilitation treatent, and the data were statistically analyzed. Results The upper and lower extremity motor scores of STREAM before treatment significantly different from those after treatment period. ( P >0.05). The lower extremity motor scores improved more were not quickly than the upper extremity. The lower extremity gained greater treatment benefit than the upper extremity after rehabilitation treatment (based on STREAM motor score ratios, P <0.05). This was especially true in the younger patients (<65 years of age). The average STREAM scores change of hemorrhage patients was higher than that of infarction patients ( P < 0.05 ). Conclusion Functional recovery of lower limb was better than the upper limb in stroke patients. Patients benefitted greater when they received rehabilitation treatment earlier. Patients with youner age recovered quicker than the aged ones. These findings are helpful for planning the rehabilitation training programme for stroke patient.