[Effects of early rehabilitation on activities of daily living and complications in acute stroke patients]

Abstract

Objective: To investigate the effects of early rehabilitation on activities of daily living (ADL) and complications in patients within 1 month after a first stroke.

Methods: 57 stroke patients were randomly divided into rehabilitation group (30 cases) and control group (27 cases). Patients in rehabilitation group received rehabilitation intervention (the main methods were therapeutic exercises, especially Bobath method) starting on average (15+/-4) days after stroke. Patients in both groups received the similar pharmological treatments. The demographic information was similar in both groups. Using the degree of deficit of neural function (DDNF,Chinese version), Barthel index and Fugl-Meyer Assessment (FMA) scale to assess all patients in pre-therapy stage and post-therapy stage.

Results: The scores of DDNF, FMA and Barthel index except for the grooming item (P=0.04, it is higher in rehabilitation group than in control group) in the 2 groups were similar at the pre-therapy stage (P>0.05). At the post-therapy stage, there was no significant difference in the difference values in the grooming item between the pre- and post-stages in the 2 groups. There were significant differences in the difference values between the pre- and post-stages in the 2 groups in eating, bed-chair transfer and short distance walking activities items put together(P=0.05). The differences between the pre- and post-stages in both groups in Barthel index items except the control of feces and urine, and bath items were significant (P</=0.01). The effects on complications were as follows: At the pre-therapy stage, the number of shoulder hand syndrome in rehabilitation group was higher than the one in control group (P=0.11), it was lower in rehabilitation group than in control group (P=0.09) at the post-therapy stage. There were no significant differences about drop foot, interior deviation foot and ankle joint contracture conditions between the 2 groups at the pre-therapy stage, but there were significant differences about the 3 conditions at the post-therapy stage (P</=0.01), and the number of 3 complications was lower in rehabilitation group than in control group. There was no significant difference in shoulder subluxation at the pre- and post-therapy stages between the 2 groups.

Conclusion: Early rehabilitation can effectively improve stroke patients' ADL, especially in eating, bed-chair transfer and short distance walking activities, and decrease the rate of complications' incidence within one month after stroke.