Han Eun Young, Kim Bo Ryun, Joo Seung-Jae, Lee Chang Sub, Kang Sa-Yoon, Kim Song-Yi, Choi Joon Hyouk, Hyun Chul Woong
Department of Rehabilitation Medicine, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, South Korea.
Department of Rehabilitation Medicine, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, South Korea.
J Stroke Cerebrovasc Dis. 2017 May;26(5):922-929. doi: 10.1016/j.jstrokecerebrovasdis.2016.10.040. Epub 2016 Dec 19.
To examine changing patterns in arterial stiffness and functional outcome in patients with subacute stroke, and to determine which parameter shows a strong correlation with the reversal of arterial stiffness, during a 3-month period of comprehensive rehabilitation therapy.
This descriptive, observational cohort study enrolled 60 patients (43 male and 17 female; average age, 62.7 years), and all received conventional rehabilitation therapy, during a 3-month period. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. Functional assessments included the 6-minute walk test (6MWT), Fugl-Meyer Assessment of hemiparetic upper and lower limbs, the functional ambulatory category, the Berg balance scale, the Korean Mini-Mental Status Examination, and the Korean-Modified Barthel Index. All measurements were conducted at baseline and 1 and 3 months after stroke onset.
Rehabilitation therapy resulted in a statistically significant improvement in baPWV since 3 months post stroke. Another functional outcome measure showed statistically significant improvements since 1 month after rehabilitation. Multivariable linear regression analysis revealed that a change in baPWV was significantly correlated with changes in the 6MWT.
Three months of comprehensive rehabilitation therapy led to statistically significant improvements in arterial stiffness and functional outcomes during the subacute phase of stroke. Thus, the comprehensive rehabilitation focused on improving gait endurance would be warranted in subacute stroke patients.
在为期3个月的综合康复治疗期间,研究亚急性脑卒中患者动脉僵硬度和功能结局的变化模式,并确定哪个参数与动脉僵硬度的逆转有强相关性。
这项描述性观察性队列研究纳入了60例患者(43例男性和17例女性;平均年龄62.7岁),所有患者在3个月期间均接受了常规康复治疗。测量肱踝脉搏波速度(baPWV)作为动脉僵硬度指标。功能评估包括6分钟步行试验(6MWT)、偏瘫上下肢的Fugl-Meyer评估、功能步行分类、伯格平衡量表、韩国简易精神状态检查和韩国改良巴氏指数。所有测量均在卒中发作的基线以及发作后1个月和3个月进行。
自卒中后3个月起,康复治疗使baPWV有统计学意义的改善。另一项功能结局指标自康复后1个月起有统计学意义的改善。多变量线性回归分析显示,baPWV的变化与6MWT的变化显著相关。
3个月的综合康复治疗使卒中亚急性期的动脉僵硬度和功能结局有统计学意义的改善。因此,对于亚急性脑卒中患者,有必要进行以改善步态耐力为重点的综合康复治疗。