脑卒中偏瘫康复治疗疗效的动态观察

关键词：脑卒中 偏瘫 康复 运动功能 日常生活活动 治疗

Keywords:stroke,hemiplegia,rehabilitation,motor function,activities of daily living,

摘要：

      目的:通过对中风偏瘫患者6个月康复治疗的疗效观察,了解中风肢体功能障碍恢复的进程。方法:对30例患者于急性期至病程6个月进行常规康复治疗。使用Fugl-Meyer运动功能评测,ADL评测选择FIM方法中反映上下肢功能的亚项,评测分别于治疗前、病程1个月、3个月、6个月时进行,比较各阶段康复疗效。结果:上肢、腕、手、下肢运动功能和上、下肢ADL各阶段均有显著改善(P<0.01),FM各阶段恢复程度比较,上肢、手、下肢第一阶段与第二阶段差异无显著性意义(P>0.05)。腕活动P<0.05,第二阶段优于第一阶段。第二、三阶段下肢恢复程度差异无显著性意义(P>0.05),而上肢、腕、手恢复明显较前一期减弱(P<0.01)。ADL各阶段改善程度比较:下肢第二阶段改善明显优于第一、三阶段(P<0.01),上肢第三阶段提高明显减慢。结论:中风偏瘫康复治疗上、下肢运动功能及相关ADL在前6个月持续明显改善,运动功能提高前3个月明显优于后3个月,但下肢改善无减弱趋势。

Abstract:

      Objective:To observe the time course and degree of the recovery of extremities after stroke.Method:30 patients with acute stroke were underwent consecutive periods of rehabilitation from early time to 6 month after stroke,Using Fugl-Meyer Motor Assessment and FIM subscores for the outcome measures. Measurements were done before the treatment and 1,3,6month after stroke respectively.Result:Significant improvements(P<0.01) were gained in movement function of upper limb,lower limb,hand,wriste during every stage, as well as in disability (FIM).To compared degree of progress in three stages,we found that stage 1 and stage 2 were better than stage 3(3 to 6 month) in general. But the function improvement of lower limb were still obvious during stage 3.Considering improvement of FIM in lower limb,stage 2 was the most important stage among all three stages. Conclusion:Function improvements were significantly improved in all 3 stages of first 6 month.Improvements in first 3 months is marked than the later 3 months.