Jørgensen H S, Nakayama H, Raaschou H O, Olsen T S
Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark.
Arch Phys Med Rehabil. 1995 Jan;76(1):27-32. doi: 10.1016/s0003-9993(95)80038-7.
Time course and degree of the recovery of walking function after stroke and the influence of initial lower extremity (LE) paresis were studied prospectively in a community-based population of 804 consecutive acute stroke patients. Walking function and degree of LE paresis were assessed weekly using the Barthel index and the Scandinavian Neurological Stroke scale, respectively. Initially, 51% had no walking function, 12% could walk with assistance, and 37% had independent walking function. At the end of rehabilitation, 21% had died, 18% had no walking function, 11% could walk with assistance, and 50% had independent walking function. Recovery of walking function occurs in 95% of the patients within the first 11 weeks after stroke. The time and the degree of recovery are related to both the degree of initial impairment of walking function and to the severity of LE paresis, p < .0001. A valid prognosis of walking function in patients with initially no/mild/moderate leg paresis can be made in 3 weeks, and further recovery should not be expected after 9 weeks. A valid prognosis of walking function in patients with initially severe leg paresis or paralysis can be made in 6 weeks, and further improvement of walking function should not be expected later than 11 weeks after stroke.
在一个以社区为基础的、连续纳入804例急性卒中患者的人群中,对卒中后步行功能恢复的时间进程和程度以及初始下肢轻瘫的影响进行了前瞻性研究。分别使用巴氏指数和斯堪的纳维亚神经卒中量表每周评估步行功能和下肢轻瘫程度。最初,51%的患者没有步行功能,12%的患者在辅助下可以行走,37%的患者有独立步行功能。在康复结束时,21%的患者死亡,18%的患者没有步行功能,11%的患者在辅助下可以行走,50%的患者有独立步行功能。95%的患者在卒中后的前11周内出现步行功能恢复。恢复的时间和程度与步行功能的初始损害程度以及下肢轻瘫的严重程度均相关,p <.0001。对于初始无/轻度/中度腿部轻瘫的患者,可在3周内对步行功能做出有效的预后判断,9周后不应期望有进一步恢复。对于初始严重腿部轻瘫或瘫痪的患者,可在6周内对步行功能做出有效的预后判断,卒中后11周后不应期望步行功能有进一步改善。