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早期神经肌肉康复方案能否改善偏瘫性中风后的残疾状况?一项初步研究。

Can Early Neuromuscular Rehabilitation Protocol Improve Disability after a Hemiparetic Stroke? A Pilot Study.

作者信息

Yazdani Mahdi, Chitsaz Ahmad, Zolaktaf Vahid, Saadatnia Mohammad, Ghasemi Majid, Nazari Fatemeh, Chitsaz Abbas, Suzuki Katsuhiko, Nobari Hadi

机构信息

Faculty of Sport Sciences, University of Isfahan, Isfahan 81746-7344, Iran.

Isfahan Neurosciences Research Centre, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan 81839-83434, Iran.

出版信息

Brain Sci. 2022 Jun 22;12(7):816. doi: 10.3390/brainsci12070816.

Abstract

The impairment of limb function and disability are among the most im portant consequences of stroke. To date, however, little research has been done on the early reha bilitation trial (ERT) after stroke in these patients. The purpose of this study was to evaluate the impact of ERT neuromuscular protocol on motor function soon after hemiparetic stroke. The sample included twelve hemiparetic patients (54.3 ± 15.4 years old) with ischemic stroke (n = 7 control, n = 5 intervention patients). ERTwas started as early as possible after stroke and included passive range of motion exercises, resistance training, assisted standing up, and active exercises of the healthy side of the body, in addition to encouraging voluntary contraction of affected limbs as much as possible. The rehabilitation was progressive and took 3 months, 6 days per week, 2-3 h per session. Fu gle-Meyer Assessment (FMA), Box and Blocks test (BBT) and Timed up and go (TUG) assessments were conducted. There was a significantly greater improvement in the intervention group com pared to control: FMA lower limbs ( = 0.001), total motor function ( = 0.002), but no significant difference in FMA upper limb between groups ( = 0.51). The analysis of data related to BBT showed no significant differences between the experimental and control groups ( = 0.3). However, TUG test showed significant differences between the experimental and control groups ( = 0.004). The most important finding of this study was to spend enough time in training sessions and provide adequate rest time for each person. Our results showed that ERT was associated with improved motor function but not with the upper limbs. This provides a basis for a definitive trial.

摘要

肢体功能障碍和残疾是中风最重要的后果之一。然而,迄今为止,针对这些中风患者的早期康复试验(ERT)的研究很少。本研究的目的是评估ERT神经肌肉方案对偏瘫性中风后运动功能的影响。样本包括12名偏瘫性缺血性中风患者(年龄54.3±15.4岁),其中7名作为对照组,5名作为干预组。ERT在中风后尽早开始,除了尽可能鼓励患侧肢体自主收缩外,还包括被动关节活动度训练、阻力训练、辅助站立以及健侧肢体的主动训练。康复训练循序渐进,为期3个月,每周6天,每次2至3小时。进行了Fugl-Meyer评估(FMA)、方块搭积木测试(BBT)和定时起立行走测试(TUG)。与对照组相比,干预组有显著更大的改善:FMA下肢(P = 0.001)、总运动功能(P = 0.002),但两组间FMA上肢无显著差异(P = 0.51)。BBT相关数据分析显示实验组和对照组之间无显著差异(P = 0.3)。然而,TUG测试显示实验组和对照组之间有显著差异(P = 0.004)。本研究最重要的发现是在训练课程中要花费足够的时间并为每个人提供充足的休息时间。我们的结果表明,ERT与运动功能改善相关,但与上肢无关。这为确定性试验提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/979b/9313239/e8c39ac50c30/brainsci-12-00816-g001.jpg

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