Law Ying Man, Feng Lan Fang, Liang Qui, Meng Li Jiao, Shen Peng, Yu Shuai Jiang, Pao Wing Yi
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Jockey Club Intergenerational Art Centre, Tung Wah Group of Hospitals, Hong Kong SAR, China.
Cerebrovasc Dis Extra. 2018;8(2):90-95. doi: 10.1159/000490312. Epub 2018 Jul 13.
Locked-in syndrome (LIS) results from a brainstem lesion in the pons. Ischemic stroke is the most common etiology of LIS. People with LIS have poor mobility with serious complications due to immobilization. Benefits of exercise after stroke have been widely reported. However, little is known about what and how much exercise should be prescribed for these patients.
To explore and evaluate the effect of exercise on the physical recovery of people with LIS after stroke.
We searched the following databases (last searched August 2017): EMBASE, MEDLINE, PubMed, CINAHL, AMED, PEDro, Cochrane Central Register of Controlled Trials, REHABDATA, Google Scholar, WANFANG, CNKI, and CQVIP. Handsearching of relevant journals and reference lists was also performed. The Oxford Centre for Evidence-Based Medicine was used to assess the evidence level of the included studies.
We identified 5 papers from 207 papers involving 35 cases; 26 cases had various degrees of improvement in physical performance after exercise; 9 cases had no change. Five types of exercises and prescriptions were adopted. Study designs and interventions were heterogeneous. All studies contained mixed rehabilitation interventions. A total of 8 different outcome measurement tools have been reported in the studies.
Studies indicate a positive trend of effect of exercise for physical recovery of people with LIS after stroke including the improvement of muscle strength, tone, walking ability, and activity in daily living. Mixed physical exercises were used. The effects were not significant. No adverse event has been reported. The quality of the existing evidence is relatively low since the papers were either case series or case studies. Further studies are needed on exercise types and dosages for better prescriptions for people with LIS after stroke. This may help to extend their lives with better control of the complications and to improve their quality of life.
闭锁综合征（LIS）由脑桥的脑干病变引起。缺血性中风是LIS最常见的病因。LIS患者因活动受限而行动能力差且伴有严重并发症。中风后运动的益处已被广泛报道。然而，对于这些患者应该规定何种运动以及运动量为多少却知之甚少。
探讨并评估运动对中风后LIS患者身体恢复的影响。
我们检索了以下数据库（最后检索时间为2017年8月）：EMBASE、MEDLINE、PubMed、CINAHL、AMED、PEDro、Cochrane对照试验中心注册库、康复数据库、谷歌学术、万方、知网和维普。还对手检相关期刊及参考文献列表进行了检索。采用牛津循证医学中心来评估纳入研究的证据水平。
我们从207篇论文中筛选出5篇，涉及35例患者；26例患者运动后身体机能有不同程度改善；9例无变化。采用了五种运动类型及处方。研究设计和干预措施具有异质性。所有研究均包含综合康复干预。研究中总共报告了8种不同的结局测量工具。
研究表明，运动对中风后LIS患者的身体恢复有积极作用趋势，包括肌肉力量、肌张力、步行能力和日常生活活动能力的改善。采用了综合体育锻炼。效果不显著。未报告不良事件。由于这些论文均为病例系列或病例研究，现有证据质量相对较低。需要进一步研究运动类型和剂量，以便为中风后LIS患者制定更好的处方。这可能有助于更好地控制并发症从而延长他们的生命，并提高他们的生活质量。
