Gialanella B
Fondazione Salvatore Maugeri, Clinica del Lavoro e della Riabilitazione, Istituto di Gussago, Divisione di Recupero e Rieducazione Funzionale, Gussago, Italia.
Clin Ter. 2001 Sep-Oct;152(5):291-7.
The influence of global aphasia on the outcome rehabilitation of hemiplegia has been considered in very few case studies. Aim of this study is to evaluate motor function and functional capacities of patients whit hemiplegia and global aphasia after rehabilitation.
A consecutive sample of 54 first-stroke patients was assessed. The mean age of the patients was 64.9. Assessments were made using the Barthel Index, Fugl-Meyer Scale and Standard Language Examination of Basso.
At admission 98.1% of the patients showed a complete paresis of the upper limb, while 72.2% provided a complete paresis of the lower limb. After rehabilitation 90.7% of the cases showed a complete paresis of the upper limb while 29.6% maintained the paresis of the lower limb. The lower limb had motriciy in flexor- and extensor synergies, while the upper limb only in flexor-synergies. At admission all patients showed severe or very severe disability. After rehabilitation disability was very severe in 9.2% of the patients, severe in 16.7%, moderate in 38.9% and light in 35.2%. At discharge 33.3% of the patients had a Berthel Index score above 70 while the mean score was 59.2/100. The higher self-sufficiency was detected in the personal hygiene (83% self-sufficient) and walking (61.1%); a lower degree of self-sufficiency was observed in eating, dressing and toileting (100% of the patients needed assistance). The patients aged less than 65 years showed a recovery in the functional capacities better than the level detected in patients older than 65 (p < 0.001).
These results demonstrate that patients whit hemiplegia and global aphasia recovery better functional capacities than motor function after rehabilitation.
在极少的病例研究中探讨了完全性失语对偏瘫康复结局的影响。本研究旨在评估康复后偏瘫伴完全性失语患者的运动功能和功能能力。
对54例首次卒中患者进行连续抽样评估。患者的平均年龄为64.9岁。使用巴氏指数、Fugl-Meyer量表和Basso标准语言检查进行评估。
入院时，98.1%的患者上肢完全瘫痪，72.2%的患者下肢完全瘫痪。康复后，90.7%的病例上肢仍完全瘫痪，29.6%的病例下肢仍瘫痪。下肢有屈伸协同运动，而上肢只有屈肌协同运动。入院时所有患者均表现为重度或极重度残疾。康复后，9.2%的患者残疾程度极重度，16.7%为重度，38.9%为中度，35.2%为轻度。出院时，33.3%的患者巴氏指数得分高于70，平均得分为59.2/100。个人卫生（83%能够自理）和行走（61.1%）方面的自理能力较高；进食、穿衣和如厕方面的自理能力较低（100%的患者需要帮助）。年龄小于65岁的患者功能能力恢复情况优于65岁以上的患者（p<0.001）。
这些结果表明，偏瘫伴完全性失语患者康复后功能能力的恢复优于运动功能。
