OBJECTIVE: To investigate the effects of standardized tertiary rehabilitation (STR) on promotion of the neurological functions in stroke patients with hemiplegia. METHODS: A large-sample, multi-center, randomized, controlled prospective study was conducted nationwide. 1209 stroke patients with hemiplegia, aged 40 - 80, within 11 d +/- 5 d after the onset, stabilized in vital life signs in the past one week, of 20 hospitals affiliated to medical colleges or of hospitals at the provincial level in mainland China were randomly allocated to one of the 2 baseline data-matched groups: control group (n = 599, 446 with cerebral infarction and 153 with cerebral hemorrhage) receivingroutine intervention of internal medicine, and STRgroup (n = 610, 455 with cerebral infarction and 155 with cerebral hemorrhage), receiving routine intervention and STR including physical therapy and occupational therapy (OT) in addition. Evaluation was conducted by the time of enrollment, and by the ends of the first, third, and sixth months by the national clinical neurological function defects (CNFD) scoring. RESULTS: There were no significant differences in the baseline indexes between these 2 groups. The scores of CNFD at enrollment of the patients with cerebral infarction in the STR group was 21.55, not significantly different from that of the patients with cerebral infarction in the control group (22.16), however, the scores of these patients with cerebral infarction in the STR group by the ends of the first, third, and sixth months were 16.32, and 11.48, and 8.63 respectively, all significantly lower than those of the corresponding patients in the control group (18.95, 15.57, and 13.78 respectively, all P < 0.01). The CNFD score at enrollment of the patients with cerebral hemorrhage in the STR group was 23.27, not significantly different from that of the corresponding patients in the control group (24.36), however, the scores of the patients with cerebral hemorrhage in the STR group by the ends of the first, third, and sixth months were 17.61, 11.20, and 7.95 respectively, all significantly lower than those of the corresponding patients in the control group (20.36, 15.01, and 13.57 respectively, all P < 0.01). By the end of the sixth month, the CNFD score of the cerebral infarction and hemorrhage patients in the STR group were improved by 12.79 and 15.23, both higher than the corresponding patients in the control group (8.30 and 10.65 respectively). The trend of decrease of CNFD score moved faster in the STR group than in the control group, especially at the early stage. CONCLUSION:STR significantly helps improved the neurological function in the patients with cerebral stroke accompanied with hemiplegia.
RCT Entities:
OBJECTIVE: To investigate the effects of standardized tertiary rehabilitation (STR) on promotion of the neurological functions in strokepatients with hemiplegia. METHODS: A large-sample, multi-center, randomized, controlled prospective study was conducted nationwide. 1209 strokepatients with hemiplegia, aged 40 - 80, within 11 d +/- 5 d after the onset, stabilized in vital life signs in the past one week, of 20 hospitals affiliated to medical colleges or of hospitals at the provincial level in mainland China were randomly allocated to one of the 2 baseline data-matched groups: control group (n = 599, 446 with cerebral infarction and 153 with cerebral hemorrhage) receiving routine intervention of internal medicine, and STR group (n = 610, 455 with cerebral infarction and 155 with cerebral hemorrhage), receiving routine intervention and STR including physical therapy and occupational therapy (OT) in addition. Evaluation was conducted by the time of enrollment, and by the ends of the first, third, and sixth months by the national clinical neurological function defects (CNFD) scoring. RESULTS: There were no significant differences in the baseline indexes between these 2 groups. The scores of CNFD at enrollment of the patients with cerebral infarction in the STR group was 21.55, not significantly different from that of the patients with cerebral infarction in the control group (22.16), however, the scores of these patients with cerebral infarction in the STR group by the ends of the first, third, and sixth months were 16.32, and 11.48, and 8.63 respectively, all significantly lower than those of the corresponding patients in the control group (18.95, 15.57, and 13.78 respectively, all P < 0.01). The CNFD score at enrollment of the patients with cerebral hemorrhage in the STR group was 23.27, not significantly different from that of the corresponding patients in the control group (24.36), however, the scores of the patients with cerebral hemorrhage in the STR group by the ends of the first, third, and sixth months were 17.61, 11.20, and 7.95 respectively, all significantly lower than those of the corresponding patients in the control group (20.36, 15.01, and 13.57 respectively, all P < 0.01). By the end of the sixth month, the CNFD score of the cerebral infarction and hemorrhagepatients in the STR group were improved by 12.79 and 15.23, both higher than the corresponding patients in the control group (8.30 and 10.65 respectively). The trend of decrease of CNFD score moved faster in the STR group than in the control group, especially at the early stage. CONCLUSION: STR significantly helps improved the neurological function in the patients with cerebral stroke accompanied with hemiplegia.
Authors: David H Saunders; Mark Sanderson; Sara Hayes; Maeve Kilrane; Carolyn A Greig; Miriam Brazzelli; Gillian E Mead Journal: Cochrane Database Syst Rev Date: 2016-03-24