[Clinical study of standardized tertiary rehabilitation program in promoting upper and lower limbs motor function in stroke patients].
OBJECTIVE
To investigate the effect of standardized tertiary rehabilitation (STR) on the upper and lower limbs' motor function in the patients with cerebral stroke accompanied by hemiplegia.


METHODS
1365 patients with cerebral stroke accompanied by hemiplegia enrolled sequentially from 22 hospitals were classified into two groups: cerebral infarction group and hemorrhage group, and then randomly subdivided into two groups: test group (n = 688, administered with STR in addition to routine interventions of neurological medicine) and control group (n = 677, given the routine interventions). All patients were assessed with the scale of Modified Fugl-Meyer Motor Assessment (M-FMMA) at the time of enrollment and 1, 3, and 6 months after the stroke respectively. The evaluation was blind on the part of the physician.


RESULTS
At each of the following post-stroke checkpoints, the scores of the functions in the cerebral infarction or hemorrhage test group were higher than those in the control (P < 0.01). The M-FMMA scores at the enrollment, and 1, 3, and 6 months after stroke of the cerebral infarction patients in the test group were 28, 47, 65, and 75 respectively, and the M-FMMA scores at the enrollment, and 1, 3, and 6 months after stroke of the cerebral infarction patients in the control group were 26, 37, 48, and 55 respectively. The M-FMMA scores at the enrollment, and 1, 3, and 6 months after stroke of the cerebral hemorrhage patients in the test group were 23, 44, 67, and 80 respectively, and the M-FMMA scores at the enrollment, and 1, 3, and 6 months after stroke of the cerebral hemorrhage patients in the control group were 21, 32, 46, and 55 respectively. During the STR, the scores of functional improvement of both the cerebral infarction and hemorrhage test groups were higher than those of the control groups (both P < 0.01). By the end of the 6th month after stroke, the scores of functional improvement of both the cerebral infarction and hemorrhage test groups went up by 47 and 56 respectively for the 2 test groups, while went up by 29 and 34 respectively for the 2 control groups. Compared with the control groups, the score of functional improvement of the cerebral infarction test group was 18 points higher, and that of the cerebral hemorrhage test group was 22 points higher.


CONCLUSIONS
STR significantly improves the neurological function in the patients with cerebral strokes accompanied by hemiplegia.
Department of Rehabilitation Medicine, Huashan Hospital & Rehabilitation, Shanghai Medical College, Fudan University, 200040 Shanghai, China.
Yong-shan
YS
Hu
D000368:Aged; D002543:Cerebral Hemorrhage / Q000503:physiopathology / Q000534:rehabilitation*; D002544:Cerebral Infarction / Q000503:physiopathology / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D011597:Psychomotor Performance; D020127:Recovery of Function; D016037:Single-Blind Method; D034941:Upper Extremity / Q000503:physiopathology*