Department of Neurology, Shanghai Hongkou District Jiangwan Hospital, The First Rehabilitation Hospital Affiliated to Shanghai University of Medicine & Health Sciences, 1878 Sichuan North Road, Shanghai 200081, China.
Department of Infectious, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai 200072, China.
Biomed Res Int. 2021 Aug 28;2021:1940549. doi: 10.1155/2021/1940549. eCollection 2021.
To investigate effects of different intervention time points of early rehabilitation on patients with acute ischemic stroke.
We enrolled patients diagnosed with acute ischemic stroke in our hospital's rehabilitation ward from November 2013 to December 2015. Patients were randomly assigned to an ultraearly rehabilitation program (started within 72 hours of onset) or an early rehabilitation program (started from 72 hours to 7 days after onset). The efficacy was assessed by the NIH Stroke Scale (NIHSS) International, Barthel Index, and Fugl-Meyer Assessment at one and three months after rehabilitation. Data were analyzed by variance analysis of two-factor repeated measurement. Covariance analysis was used to adjust confounding factors for the determination of statistical differences.
41 patients were enrolled in the ultraearly rehabilitation group, while 45 patients were in the early rehabilitation group. There were no differences between the two groups at baseline data. Compared with the early rehabilitation group, patients in the ultraearly rehabilitation group have significantly improved NIHSS score, BMI score, and FMA score at one month and three months ( < 0.001). After adjusting for confounding factors (gender, age, severity of NIHSS score, location of stroke, hypertension, diabetes, atrial fibrillation, and coronary heart disease), the significant difference still existed between the two groups at one month and three months ( < 0.001).
Our study indicated a higher efficacy in the ultraearly rehabilitation group than the early rehabilitation group. The result suggests an important practical significance in favor of the clinical treatment of stroke.
探讨不同早期康复介入时间点对急性缺血性脑卒中患者的影响。
选取 2013 年 11 月至 2015 年 12 月在我院康复病房住院的急性缺血性脑卒中患者。将患者随机分为超早期康复组(发病后 72 小时内开始)和早期康复组(发病后 72 小时至 7 天开始)。在康复后 1 个月和 3 个月,采用 NIH 卒中量表(NIHSS)国际、Barthel 指数和 Fugl-Meyer 评定评估疗效。采用双因素重复测量方差分析进行数据分析。协方差分析用于调整混杂因素,以确定统计差异。
超早期康复组 41 例,早期康复组 45 例。两组基线数据无差异。与早期康复组相比,超早期康复组患者在 1 个月和 3 个月时 NIHSS 评分、BMI 评分和 FMA 评分明显改善(<0.001)。在调整混杂因素(性别、年龄、NIHSS 评分严重程度、卒中部位、高血压、糖尿病、心房颤动和冠心病)后,两组在 1 个月和 3 个月时仍存在显著差异(<0.001)。
本研究表明超早期康复组的疗效优于早期康复组。结果提示对脑卒中的临床治疗具有重要的实际意义。