| Objective:In this study,the clinical case data of patients with post-stroke lower extremity motor dysfunction rehabilitation treatment were collected,including the general condition,clinical characteristics,and evaluation results of lower extremity motor function,balance function,walking function,and daily living ability of the patients before and after rehabilitation treatment.The distribution of cases was analyzed,the improvement of lower extremity motor dysfunction and the improvement of daily living ability of patients with different rehabilitation measures were analyzed,and the influencing factors of rehabilitation treatment effect were discussed,so as to provide a basis for the hospital to formulate personalized rehabilitation treatment plans in the future.Method:According to the unified inclusion and exclusion criteria,236 patients who were transferred to the Department of Rehabilitation Medicine of a hospital in Changchun City for treatment of post-stroke lower extremity motor dysfunction from December2019 to November 2021 were selected,and the gender,age,and onset time,number of onsets,type of stroke,side of hemiplegic limb,duration of disease,rehabilitation intervention time,body mass index,concomitant diseases,complications after admission,other functional disorders,FMA-LE scale score,BBS score,Holden walking function level,MBI score of patients at admission and discharge were collected.EPi Data 3.0 was used to establish a database and input case information,IBM SPSS Statistics 24.0 software was used for statistical analysis,and the measurement data met the normal distribution with the mean and standard deviation,and non-normal distribution with the use of quartiles for statistical description;within the group paired t test was used for comparison before and after treatment,and independent samples t test was used for comparison between two groups.The count data were expressed by frequency and constituent ratio,and the（?）~2test was used for comparison between groups.The Wilcoxon signed rank sum test of paired samples was used for comparison of rank data before and after treatment,and the Mann-Whitney U test was used for comparison between groups.Logistic regression was used to analyze the influencing factors,and P<0.05 was defined as a statistically significant difference.Results:1.Among the 236 stroke patients in this study,male patients accounted for70.3%and female patients accounted for 29.7%;the age range was 20-87 years old,and the majority of patients were 45-59 years old and 60-74 years old;Hemorrhagic stroke accounted for 69.5%;first-onset stroke patients accounted for 74.6%;2.There were statistical differences in age distribution among stroke patients of different genders（P<0.05）,and the age of female patients was higher than that of male patients;there were statistical differences in stroke type,incidence frequency and seasonal distribution of stroke patients of different ages.（P<0.05）,the older patients had a higher proportion of ischemic stroke,and with the increase of age,the proportion of patients with recurrent stroke increased;among patients with ischemic stroke,the age group and the incidence of stroke There was a statistical difference（P<0.05）;the distribution of stroke incidence season among different types of stroke patients was statistically different（P<0.05）,and the incidence of hemorrhagic stroke patients was higher in winter;3.For stroke-associated diseases,82.2%of stroke patients were associated with hypertension;35.2%of patients with diabetes;21.6%of patients with hyperlipidemia;14.0%of patients with hyperhomocysteinemia;20.3%of patients with heart disease;7.2%of patients with other diseases;with age,the proportion of patients with hyperhomocysteinemia and heart disease increased（P<0.05）;The proportions of ischemic stroke with diabetes and hyperhomocysteinemia were higher,while the proportions of hemorrhagic strokes with hypertension were higher（P<0.05）;4.The proportion of stroke patients with all complications was 28.4%,of which shoulder joint subluxation accounted for 7.2%,and pulmonary infection accounted for6.8%;the proportion of hemorrhagic stroke complicated by pulmonary infection was significantly higher than that of ischemic stroke（P<0.05）;The proportion of patients with pulmonary infection in patients who took conventional rehabilitation therapy was significantly higher than that in patients who received conventional rehabilitation combined with low frequency r TMS therapy（P<0.05）;5.Among all the research subjects,34.7%of the patients had shallow sensory disturbance;32.6%had dysphagia;8.1%had fecal incontinence,and 23.3%had constipation;The proportion of shallow sensation injury and dysphagia was significantly higher for female patients than that of male patients（P<0.05）;the proportion of dysphagia in older patients was higher（P<0.05）;the proportion of incontinence in patients with hemorrhagic stroke was significantly higher than that in patients with hemorrhagic stroke patients with ischemic stroke（P<0.05）;6.The lower extremity motor function,balance ability,walking ability and daily living ability of patients who received conventional rehabilitation therapy and conventional rehabilitation combined with low frequency r TMS therapy were significantly improved before and after treatment（P<0.05）;patients who received conventional rehabilitation combined with low frequency r TMS therapy The total effective rate of clinical efficacy（95.1%）was significantly higher than that of the patients in the simple conventional rehabilitation group（79.1%）（P<0.05）;7.Age,complication or not and superficial sensory dysfunction are independent influencing factors of lower extremity motor function in stroke patients.Among them,compared with patients aged 20-44,the OR（95%CI）of stroke patients aged 45-59,60-74 and 75-87 were 6.345（1.644,24.483）,6.251（1.601,24.410）and 4.955（1.173,20.936）.Stroke patients with complications and superficial sensory dysfunction had poor lower extremity motor function recovery after treatment.Compared with those without complications and superficial sensory dysfunction,the ORs（95%CI）were 1.910（1.031,3.541）and 2.849（1.585,5.121）respectively.Age,complication or not,superficial sensory dysfunction and incontinence are independent influencing factors of life self-care ability of stroke patients.Compared with patients aged 20-44,the OR（95%CI）of stroke patients aged 45-59,60-74 and 75-87 were10.563（1.406,79.335）,19.708（2.559,151.756）,23.699（2.906,193.279）respectively;stroke patients with complications,superficial sensory dysfunction,and incontinence have poorer improvement in daily living ability after treatment,and OR（95%CI）were 2.548（1.333,4.873）,2.564（1.393,4.720）,11.068（2.196,55.780）respectively compared with patients without complications,no superficial sensory dysfunction and incontinence.Conclusion:1.Most of the stroke patients treated in this hospital are ischemic stroke,mainly male,and the age groups are concentrated in 45-59 years old and 60-74 years old;with the increase of age,the proportion of patients with recurrent stroke increases;The incidence of hemorrhage stroke patients is higher in winter;2.Diabetes and hyperhomocysteinemia are more common in ischemic stroke,and hypertension is more common in hemorrhagic stroke;3.The lower extremity motor function,balance ability,walking ability and daily living ability of patients who received conventional rehabilitation therapy and conventional rehabilitation combined with low frequency r TMS therapy were significantly improved before and after treatment;the clinical efficacy of patients receiving conventional rehabilitation combined with low frequency r TMS therapy was overall The effective rate was significantly higher than that of the patients in the simple conventional rehabilitation group;4.Advanced age,complications and superficial sensory dysfunction are risk factors for lower extremity motor function in stroke patients;advanced age,complications,superficial sensory dysfunction,and urinary and fecal incontinence are the risk factors of self-care ability for stroke patients. |
PDF Full Text Request