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作者单位

² 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. ³ 北京小汤山医院天坛 小汤山康复中心. ¹ 北京 100070 首都医科大学附属北京 天坛医院康复医学科.

刊名

Chinese Journal of Stroke

年份

2025

卷号

Vol.20 No.11

页码

1411-1419

ISSN

1673-5765

关键词

Infarct location Infarct volume Upper limb function rehabilitation 上肢功能康复 梗死体积 梗死部位 缺血性卒中

摘要

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

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