Acute Ischemic Stroke In Patients With Early Rehabilitation Clinical Research

Part1 clinical research on the beginning intertevention time of earlyrehabilitation in acut ischemic strokeObjective:This research main goal is to measure acute ischemic stroke patients with early rehabilitation intervention time and validity.Methods:86 first-onset stroke patients(aged 56-85 years),confirmed by brain CT or MRI scanning, no statistical differences of neural function evaluation of the baseline.were subjected to a early rehabilitation program(72 hours within the onset of began to recover) or an routine rehabilitation project(72 hours to 7 days after onset of began to recover) in two groups only when the vital signs were stable, no neurological symptoms progress, and capable to go with the programs of treatment.Early rehabilitation operation in accordance with Stroke rehabilitation guide in China for the standardization of the scheme. The efficacy was respectively assessed by the scales of NIHtroke Seale,Barthel index.and Fugl-Meyer assesement. After 1-month and 3-months period of rehabilitation an endpoint evaluation was performed. Data were analyzed by student-f test and chi-square test.Results:No significant differences were found in basal demographic characteristics, disease severity and neural scale evaluations between two treatment groups(P>0.05). A significant improvement was found in both early rehabilitation therapy and routine rehabilitation intervention in the change of the scores in NIHSS,and Fugl-Meyer assesement at the end of 1 month and 3 months in comparison to the previos assessment(P <0.001),.When 1-month and 3-months rehabilitation period was over a great treatment effect appeared inneurological deficit sympotoms 、activities of daily living andmotor function(P < 0.05),which by the end of March,the significant differences were statistic in activities of daily living andmotor function(P <0.001),and two groups of patients in the process of rehabilitation treatment, no adverse events occurred.Conclusion:The early rehabilitation in acute ischemic stroke can promote brain function and neural plasticity, nerve function defect in patients, daily life ability, and limb motor function has a promoting effect, Our research indicates a more greater efficacy exist in early rehabilitation therapy compared to routine rehabilitation therapy and the treatment was safe. These results indicate an important practical significance to guide the clinical treatment in brain stroke.Part2 Research on post stroke depression associated with early ischemic stroke rehabilitationObjective :To observe early rehabilitation of The acute ischemic stroke and the correlation of the post stroke depression(PSD).Methods: 88 cases patients with PSD were randomly divided into in treatment group(45 patients) and control group(43 patients).control group were given routine early rehabilition, treatment group were treated with individualized early rehabilitation :Bobath rehabilitation exercise training(including: good appearance, sit, stand, walk, such as training step by step); combined psychological intervention and antidepressant treatment.Compared the hamilton depression scale(HAMD)on treatment effective rate,U.S.national instittes of health stroke scores(NIHSS) and Activities of daily living(ADL),after treatment for 12 weeks.the chi-square statistic analysis.Results:Two groups in gender, age, occupation, level of education, the degree of depression, stroke classification and so on, there was no significant difference(P>0.05). treatment effective rate after treatment for 12 weeks of treatment group were lower than that of control group,the difference was statistically significant(P<0.05).the treatment group and control group before early rehabilitation treatment of nerve function defect degree, daily life ability, there was no significant difference(P>0.05)..After treatment, the treatment group than the control group of nerve function defect degree, there are significant difference(P < 0.05),.After treatment, the treatment group than the control group ofdaily life ability,there are more significant difference(P < 0.001).and two groups of patients in the process ofrehabilitation treatment, no adverse events occurred..Conclusion : Early rehabilitation in patients with acute ischemic stroke in the improvement of neurologic deficits and daily life ability at the same time, depression improved to a certain extent. The study found that the positive correlation between them. Worthy of clinical popularization and application.Part3 Correlative factors of acute ischemic stroke patients with early rehabilitation researchObjective :To explore the influence the effect of early rehabilitation in patients with acute ischemic stroke associated correlative factors。Methods: In Shanghai jiangwan hospital 96 cases of acute ischemic stroke patients with general condition, past medical history score,With the onset of score, Hamilton rating score, MMSE score to investigate evaluation, Spearman rank correlation with Logistic regression is adopted to improve the effect of early rehabilitation of acute ischemic stroke of single factor and multiple factors analysis.Results: Of the 96 patients, the single factor analysis showed that the culture of the patients with acute ischemic stroke degree of education(r = 0.52, t = 2.10, p = 0.032), past medical history score(r = 0.82, t = 9.71, p = 0.000), with the onset of score(r = 0.66, t = 2.23, p = 0.033), Hamilton rating score(r = 0.63, t = 3.86, p = 0.005) and MMSE score(r = 0.56, t = 2.75, p = 0.012) and the effect of early rehabilitation training. Multiple factors analysis showed that patients with acute ischemic srtoke in the early rehabilitation effect are related to these factors, the regression coefficient beta were 0.41, 1.53, 1.02, 0.51, 0.81.Conclusion:Effect of early rehabilitation in patients with acute ischemic stroke was assosciated with degree of education,past history cultural degree, grade, with the onset of score,Hamilton rating score and MMSE score.