Yen Hsiao-Ching, Pan Guan-Shuo, Jeng Jiann-Shing, Chen Wen-Shiang
Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Stroke Center & Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Neurorehabil Neural Repair. 2024 Mar 1:15459683241236443. doi: 10.1177/15459683241236443.
Early mobilization (EM) within 24 to 72 hours post-stroke may improve patients' performance and ability. However, after intravenous thrombolysis (IVT) or mechanical thrombectomy (MT), the increased risk of hemorrhagic complications impacts the implementation of early out-of-bed mobilization. Few studies have investigated EM after IVT or MT for acute ischemic stroke (AIS), and its impact in these patients is unknown.
To investigate the effect of EM on AIS treated with IVT or MT.|.
We recruited 122 patients with first AIS; 60 patients were treated with IVT, and 62 patients were treated with MT. For each IVT and MT cohort, the control groups received standard early rehabilitation, and the intervention groups received an EM protocol. The training lasted 30 minutes/day, 5 days/week until discharge.
The effectiveness of the interventions was evaluated using the motor domain of the Functional Independence Measure (FIM-motor) and the Postural Assessment Scale for Stroke Patients (PASS) at baseline, 2-week, 4-week, and 3-month post-stroke, the Functional Ambulation Category 2-week post-stroke, and the total length of stay at the stroke center.
Both IVT and MT treatment groups showed improved FIM-motor and PASS scores over time; however, only the IVT EM group had significantly improved FIM-motor performance within 1 month after stroke than the control group. Conclusion. An EM protocol with the same intervention time and session frequency per day as in the standard care protocol was effective in improving the functional ability of stroke patients after IVT.
卒中后24至72小时内的早期活动(EM)可能会改善患者的表现和能力。然而,在静脉溶栓(IVT)或机械取栓(MT)后,出血性并发症风险增加影响了早期下床活动的实施。很少有研究调查IVT或MT治疗急性缺血性卒中(AIS)后的EM情况,其对这些患者的影响尚不清楚。
研究EM对接受IVT或MT治疗的AIS的影响。
我们招募了122例首次发生AIS的患者;60例接受IVT治疗,62例接受MT治疗。对于每个IVT和MT队列,对照组接受标准早期康复治疗,干预组接受EM方案。训练持续每天30分钟,每周5天,直至出院。
在基线、卒中后2周、4周和3个月时,使用功能独立性测量的运动领域(FIM运动)和卒中患者姿势评估量表(PASS)评估干预效果,卒中后2周时的功能性步行分类,以及在卒中中心的住院总时长。
IVT和MT治疗组的FIM运动和PASS评分均随时间改善;然而,只有IVT EM组在卒中后1个月内的FIM运动表现比对照组有显著改善。结论:与标准护理方案干预时间和每日疗程频率相同的EM方案,对改善IVT后卒中患者的功能能力有效。