不同时期脑卒中患者康复训练对肌张力影响的对照研究

目的 了解不同时期脑卒中患者开始康复训练对恢复过程中肌张力平衡以及对日常生活能力的影响。方法 对2001～2002年在我科住院的急性期脑卒中患者经康复训练后第4周及第8周的肌张力、关节活动度以及Barthel指数状况与同期在其它科住院未经正规康复训练第8周后才转入我科开始康复训练的患者作对照研究。结果康复组于起病早期经过康复训练肌张力平衡改善状况随治疗时间的差异有极显著性意义(P<0.01),而对照组的这种差异则无统计学意义(P>0.50)。康复组Fugl-Myer评分随时间的差异有极显著性意义(P<0.01),而对照组的这种差异则无极显著性意义(P>0.01)。康复组Barthel指数随时间的差异有极显著性意义(P<0.01),而对照组的这种差异则无显著性意义(P>0.10)。结论 早期康复干预,可防止偏瘫痪者肢体肌张力过高而出现继发肢体功能障碍,提高临床疗效,改善日常生活自理能力(ADL),其疗效远好于后期康复干预。

A Comparative Study of the Influences of Rehabilitation Training on the Muscle-tension of Apoplexy Patients at Different Stages

Objective To understand the influences of rehabilitation training on the muscle-tensionbalance and activities of daily living (ADL) of cerebral apoplexy patients at different stages duringthe recovery process. Methods To compare and analyze the muscle-tension, range of arthrosis motionand Barthel index of the acute cerebral apoplexy patients immediately hospitalized in the Department ofRehabilitation and undergone rehabilitation training with those of the cerebral apoplexy patientshospitalized in other departments without normal rehabilitation treatment for eight weeks beforetransferred to the Department of Rehabilitation, after rehabilitation treatment for four and eight weeksduring the period from 2001 to 2002.Results First, for the treatment group which underwent rehabili-tation training at the early stage of disease, there is highly significant difference of improvement onpatients' muscle-tension balance with the treatment going on (P<0.01); while for the control group, thedifference is of no statistical significance (P<0.50). Secondly, for the treatment group, there is highlysignificant difference of the Fugl-Myer scores with the treatment going on (P<0.01); while for thecontrol group, the difference is not highly significant (P<0.01). Finally, for the treatment group, thereis highly significant difference of the Barthel index with the treatment going on (P<0.01); while forthe control group, the difference is not significant (P<0.10). Conclusion Early rehabilitationtreatment can prevent limb muscle-tension of hemiplegy patients from becoming too high to have secondarylimb function handicaps, increase clinical curative effects, and improve activities of daily living(ADL); it is much more effective than later rehabilitation treatment.