北京小汤山医院天坛小汤山康复中心Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China山东第一医科大学（山东省医学科学院）脑科学与类脑研究院Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing 102200, China1首都医科大学附属北京天坛医院康复医学科Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
Objective To explore the effects of infarct location and volume on upper limb functional rehabilitation in patients with subacute ischemic stroke. Methods A prospective study was conducted on patients with subacute ischemic stroke who were hospitalized in the Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, and the Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, from June 2022 to September 2023. Based on infarct locations ide...更多
Objective To explore the effects of infarct location and volume on upper limb functional rehabilitation in patients with subacute ischemic stroke. Methods A prospective study was conducted on patients with subacute ischemic stroke who were hospitalized in the Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, and the Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, from June 2022 to September 2023. Based on infarct locations identified by cranial MRI at admission, patients were divided into the supratentorial subcortical group, infratentorial group, and supratentorial mixed group. The severity of upper limb dysfunction in patients was evaluated using the Fugl-Meyer motor assessment-upper extremity , with scores of 0-22 points indicating severe dysfunction and 23-50 points indicating moderate dysfunction. All patients received rehabilitation treatment twice daily, 5 days a week, for 3 consecutive months. Among patients with different degrees of upper limb dysfunction, the effects of different infarct locations on upper limb functional rehabilitation were compared, and multiple linear regression analysis was used to explore the relationships between infarct locations, infarct volumes, other clinical characteristics, and upper limb functional rehabilitation. Results Repeated measures analysis of variance showed that patients with severe upper limb dysfunction had improved upper limb function at both 1 month and 3 months post-treatment compared with baseline, and the infratentorial group had better outcomes in upper limb functional rehabilitation than the supratentorial mixed group . Patients with moderate upper limb dysfunction also showed improved upper limb function at 1 month and 3 months post-treatment compared with baseline. Multiple linear regression analysis revealed that gender , infarct volume , and MoCA score were associated with FMA-UE scores at 1 month post-treatment. Gender , infarct volume , and MoCA score were associated with FMA-UE scores at 3 months post-treatment. However, age, smoking, alcohol consumption, hypertension, diabetes mellitus, hyperlipidemia, infarct location, hemiplegic side, and onset time of rehabilitation had no statistically significant association with FMA-UE scores at either 1 or 3 months post-treatment. Conclusions Rehabilitation therapy can promote upper limb function in patients with subacute ischemic stroke. For patients with severe upper limb dysfunction, the upper limb functional rehabilitation outcomes of infratentorial infarction are better than those of supratentorial mixed infarction. Gender, infarct volume, and cognitive function are associated with upper limb functional rehabilitation outcomes at 1 month and 3 months post-treatment.收起
