Department of Neurosurgery The Affiliated Hospital of Qingdao University, Qingdao, China; Neurosurgical Intensive Care Unit The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Neurosurgery The Affiliated Hospital of Qingdao University, Qingdao, China.
World Neurosurg. 2020 May;137:e183-e188. doi: 10.1016/j.wneu.2020.01.113. Epub 2020 Jan 27.
To investigate the effects of early intensive rehabilitation management on the recovery of motor function and activities of daily living in patients with moderate traumatic brain injury.
Eighty-seven patients (age range, 18-65 years) with traumatic brain injury that met the enrollment criteria were randomly divided into 2 groups. Group 1 received early and high-intensity rehabilitation management (from 7 days after injury, 7 d/wk, 4 times/d, 1 h/session) for 4 weeks; group 2 received ordinary rehabilitation (from 14 days after injury, 5 d/wk, 2 times/d, 1 h/session) for 4 weeks. The Fugl-Meyer Assessment (FMA, motor function) and Barthel Index (BI) were used to assess the daily living functional state before treatment, 3 months after injury, and 6 months after injury. The Glasgow Coma Scale (GCS) was used to assess outcomes 6 months after injury.
Three months after rehabilitation, the FMA (motor function) score was significantly higher in the early intensive intervention group versus the control group (59.83 ± 11.87 vs. 44.56 ± 8.32, respectively; P < 0.05); no significant between-group differences were found in the GCS score or BI score (P > 0.05). Six months after rehabilitation, the FMA score and BI score were significantly higher in the early intensive intervention group versus the control group (FMA: 73.18 ± 16.55 vs. 57.86 ± 10.67, P < 0.01; BI: 87.17 ± 13.85 vs. 60.68 ± 11.98, P < 0.01, respectively). The GCS score was higher in the early intensive intervention group versus the control group (4.24 ± 0.91 vs. 3.43 ± 0.88, P < 0.05, respectively) 6 months after injury.
Early intensive rehabilitation management might be more beneficial for neurologic function and activities of daily living in patients with moderate traumatic brain injury.
研究早期强化康复管理对中度创伤性脑损伤患者运动功能和日常生活活动能力恢复的影响。
符合纳入标准的 87 例创伤性脑损伤患者(年龄 18-65 岁)随机分为 2 组。组 1 接受早期高强度康复管理(伤后 7 天开始,每周 7 天,每天 4 次,每次 1 小时)4 周;组 2 接受普通康复(伤后 14 天开始,每周 5 天,每天 2 次,每次 1 小时)4 周。在治疗前、损伤后 3 个月和损伤后 6 个月,使用 Fugl-Meyer 评估(FMA,运动功能)和 Barthel 指数(BI)评估日常生活功能状态。使用格拉斯哥昏迷量表(GCS)评估损伤后 6 个月的结局。
康复 3 个月后,早期强化干预组的 FMA(运动功能)评分明显高于对照组(59.83 ± 11.87 对 44.56 ± 8.32,P < 0.05);两组 GCS 评分或 BI 评分差异无统计学意义(P > 0.05)。康复 6 个月后,早期强化干预组的 FMA 评分和 BI 评分明显高于对照组(FMA:73.18 ± 16.55 对 57.86 ± 10.67,P < 0.01;BI:87.17 ± 13.85 对 60.68 ± 11.98,P < 0.01)。康复后 6 个月,早期强化干预组的 GCS 评分高于对照组(4.24 ± 0.91 对 3.43 ± 0.88,P < 0.05)。
早期强化康复管理可能更有利于中度创伤性脑损伤患者的神经功能和日常生活活动能力。