Turk J Med Sci. 2019 Feb 11;49(1):318-326. doi: 10.3906/sag-1808-83.
BACKGROUND/AIM: Following stroke, damage to the central nervous system and adaptive changes in muscle tissue are factors responsible for the loss of muscle strength. Even though it is suggested that early physiotherapy and mobilization prevent structural adaptive changes in muscle tissue, studies regarding this issue are insufficient. The aim of this study is to investigate the effects of early physiotherapy and mobilization on quadriceps muscle thickness (QMT) in stroke patients.
Twelve stroke patients who were admitted to the neurology intensive care unit and 13 healthy controls were included in the study. QMT was examined at admission and discharge for each subject. Additionally, functional extremity movements, balance, and functional ambulation status were evaluated with the Stroke Rehabilitation Assessment of Movement Scale (STREAM). All of the patients were mobilized as early as possible by a physiotherapist and included in a treatment program consisting of the neurodevelopmental Bobath approach.
The patients’ QMT values at admission and discharge were found to be similar to those of the healthy control group (P > 0.05). When the patients’ QMT at the time of admission and discharge were compared, it was seen that the affected side and the nonaffected side were similar (P > 0.05). Additionally, when the admission and discharge results were compared, improvements in functional extremity movements, balance, and functional ambulation levels were observed (P < 0.05).
It can be seen that QMT can be preserved and functional improvements can be provided through intense physiotherapy and mobilization initiated in the early period following stroke.
背景/目的：中风后，中枢神经系统损伤和肌肉组织的适应性变化是导致肌肉力量丧失的因素。尽管有研究表明早期物理治疗和活动可以预防肌肉组织的结构性适应性变化，但关于这个问题的研究还不够充分。本研究旨在探讨早期物理治疗和活动对中风患者股四头肌厚度（QMT）的影响。
本研究纳入了 12 名入住神经内科重症监护病房的中风患者和 13 名健康对照者。对每位受试者的 QMT 在入院时和出院时进行检查。此外，还使用运动评估量表（STREAM）评估了四肢的功能运动、平衡和功能性步行状态。所有患者都由物理治疗师尽早进行活动，并纳入包含神经发育 Bobath 方法的治疗方案。
患者入院和出院时的 QMT 值与健康对照组相似（P > 0.05）。比较患者入院和出院时的 QMT 值时，发现患侧和非患侧相似（P > 0.05）。此外，比较入院和出院结果时，观察到四肢功能运动、平衡和功能性步行水平都有所改善（P < 0.05）。
可以看出，通过中风后早期开始的强化物理治疗和活动，可以保持 QMT 并提供功能改善。
