| Objective: To compare the effects of rehabilitation therapy on limb motor function,self-care ability of daily living and depression in patients with stroke,and to evaluate the safety of stroke rehabilitation.The prognosis of patients with stroke,so as to provide the best starting time for stroke rehabilitation to determine the clinical basis.Methods: 87 cases of ischemic stroke were collected from Febuary,2015 to Febuary,2016 in The department of neuromedicine of the first people’s hospital in Yancheng 。 All the cases were accorded with the guideline of Diagnosis and Treatment of Acute Ischemic Stroke in China(2010 edition).Were randomly divided into two groups: rehabilitation group(2d group)and rehabilitation group(14d group),with complete remission of acute stroke and acute phase of stroke.On the basis of conventional treatment,2d group in the acute stage of acute complete remission after 3 days of rehabilitation training;14d group in the acute phase of acute remission after 14 days of rehabilitation training,instruct patients and their families to be required daily training.Statistical scale was performed at the beginning of rehabilitation training and 3 months after intervention.The number of serious adverse events in each group was recorded and the safety comparison was made.The Fugl-Meyer motor function score was used to evaluate the limb motor function.Barthel index and SF-36 health scale were used to assess the activities of daily living.Hamilton Depression Scale and Hamilton Anxiety Scale were used to diagnose depression and anxiety.SPSS19.0 software was used for statistical analysis.Results: 1.Cases of dislocation: 2d group of 44 cases,3 months after the fall off 5 cases,0 deaths,the number of effective cases 39;14d group of patients in 43 cases after 3 months out of 7 cases,0 deaths,the number of effective cases 36.2.The number of serious adverse events: 2d group 3 months after follow-up,1 people relapse,death 0 people;14d group 2 people relapse,death 0 people.There was no difference between the two groups.3.Neurological function assessment results:NIHSS score was 20.03 ± 1.87 in the study,NIHSS score was 19.68 ± 4.52 in the 14-day group,F = 0.053,P> 0.05.NIHSS score was 9.72 ± 5.37 in 2d group,12.14 ± 2.76 in 14 d group,F = 5.875,P <0.05.The Fugl-Meyer motor function score was 22.46 ± 6.76 in the group,36 cases in the 14 d group.The Fugl-Meyer motor function score was 22.67 ± 6.98,F = 0.017,P > 0.05.After 3 months of treatment,Fugl-Meyer motor function score was 65.21 ± 13.27 in 2d group,Fugl-Meyer motor function score was 52.67 ± 14.28 in 14 d,F = 15.53,P <0.01.4.The ADLresults: The score of Barthel index was 19.44 ± 6.34 in the 2d group,16.56 ± 6.96 in the 14 d group and 16.56 ± 6.96 in the 14 d group,F = 0.006,P> 0.05 in the activity of daily living.After 3 months of treatment,the score of Barthel index score was 76.87±12.68 in 2d group,62.85 ± 11.69 in 14 d group,F = 4.54,P <0.05.The score of SF-36 health scale was 41.87 ± 12.68 in group 2d,45.21 ± 13.92 in group 14,and F = 1.182 in 14 d group.The score of SF-36 health score was 76.99 ± 20.29 in 2d group,SF-36 health score score in group 14 was 66.77 ± 18.09,F = 5.267,P <0.05.5.Assessment of mental status :The score of Hamilton depression scale was 45.87 ± 16.40 in group 2d and 45.39 ± 9.05 in group 14 d,F = 0.018,P> 0.05.The score of Hamilton depression scale was 45.39 ± 9.05.After 3 months of treatment,the Hamilton Depression Scale score was 29.06 ± 11.48 in the 2d group,34.23 ± 5.43 in the 14 d group,F = 6.052,P <0.05.The Hamilton Anxiety Scale score was 33.53 ± 5.74 in the 2d group and 33.26 ± 2.77 in the 14 d group,F = 0.066,P> 0.05.After 3 months of treatment,the Hamilton Anxiety Scale score was 22.53 ± 5.74 in 2d group,and 25.26 ± 2.77 in 14 d group,F = 6.691,P <0.05.Conclusion: 1.There was no significant difference in the safety of rehabilitation training between the 2 days after complete remission and 14 days after complete remission in the acute phase of acute stroke.After 3 months of rehabilitation,neurological function and daily living ability of 2d group were better than that of 14 d group,and earlier rehabilitation training could improve the motor function of the limbs and enhance the ability of daily life and benefit the patients.The depression and anxiety of 2d group were lower than that of 14 d group,which may be related to earlier rehabilitation therapy,increased limb motor function and daily living ability of patients,benefited patients and reduced the degree of depression and anxiety.4.Because of the small sample size of this study,we should further carry out large-scale clinical trials to explore the timing,methods and intensity of early rehabilitation of stroke so as to better guide and standardize the tertiary rehabilitation system of stroke Of the operation. |
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