Clinical And Experimental Studies On The Effects Of Rehabilitation Training For Function Recovery Of Ischemic Stroke

PartⅠ;Effects of standardized three-stage rehabilitation treatment on neurological deficit scores and ADL in ischemic stroke patientsObjective;To explore the effects of standardized three-stage rehabilitation treatment on the neurological deficit scores(NDS)and ADL in ischemic stroke patients.Methods;164 ischemic stroke patients were randomly recruited into rehabilitative and control groups.The NDS and Modified Barthel Index(MBI)were evaluated and analyzed at the recruitment, the end of 1st,3rd and 6th month separately after stroke.Results;No significant differences were found in the NDS and MBI between the rehabilitative and the control groups at the recruitment.The NDS of the control group descended gradually at the recruitment,the end of 1st,3rd and 6th month,but the significant differences were found only at the end of 1st month and 3rd month comparing with previous assessments.The NDS decrements in rehabilitative group were bigger than that in the control at the end of 1st,3rd and 6th month,and significant differences were found between neighboring evaluations in rehabilitative group.The MBI of the control group increased gradually at the recruitment,the end of 1st,3rd and 6th month,but the significant differences were found only at the end of 1st month and 3rd month comparing with previous assessment.The MBI increments in rehabilitative group were bigger than that in the control group at the end of 1st,3rd and 6th month,and significant differences were found between neighboring evaluations in rehabilitative group.Conclusion; Standardized three-stage rehabilitation treatment could decrease NDS and increased ADL in ischemic stroke patients.PartⅡ;Effects of standardized three-stage rehabilitation treatment on motor function in ischemic stroke patientsObjective;To explore the effects of standardized three-stage rehabilitation treatment on the motor function in ischemic stroke patients. Methods;164 ischemic stroke patients were randomly recruited into rehabilitative and control groups.The Simplified Fugl-Meyer Assessment (FMA)were evaluated and analyzed at the recruitment,the end of 1st,3rd and 6th month separately after stroke.Results;No significant differences were found in the total FMA,upper limb FMA and lower limb FMA between the rehabilitative and the control groups.The total FMA of the control group increased gradually at the recruitment,the end of 1st,3rd and 6th month,but the significant differences were found only at the end of 1st month and 3rd month comparing with previous assessments.The total FMA increments in rehabilitative group were bigger than that in the control at the end of 1st,3rd and 6th month,and significant differences were found between neighboring evaluations in rehabilitative group.The upper limb FMA of the control group gradually increased,but the significant differences were found only at the end of 3rd month comparing with 1st month assessment.The increments of upper limb FMA of the rehabilitative group were bigger that that of the control at 3rd and 6th month,and there were significant differences between the neighboring evaluations in rehabilitative group.The lower limb FMA of the control group gradually increased,but the significant differences were found only at the end of 3rd month.The increments of lower limb FMA of the rehabilitative group were bigger that that of the control,and there were significant differences between the neighboring evaluations in rehabilitative group.Conclusion;Standardized three-stage rehabilitation treatment could increase motor function in ischemic stroke patients.PartⅢ;Effects of standardized three-stage rehabilitation treatment on functional comprehensive assessment in ischemic stroke patientsObjectives;To explore the effects of standardized three-stage rehabilitation treatment on the comprehensive functional abilities in ischemic stroke patients.Methods;164 ischemic stroke patients were randomly recruited into rehabilitative and control groups.The Functional Comprehensive Assessment(FCA)were evaluated and analyzed at the recruitment,the end of 1st,3rd and 6th month separately after stroke. Results;The results indicated that no significant differences were found in the total FCA,motor FCA and cognitive FCA between the rehabilitative and the control groups.The total FCA of the control group increased gradually at the recruitment,the end of 1st,3rd and 6th month,but the significant differences were found only at the end of 1st month and 3rd month comparing with previous assessments.The total FCA increments in rehabilitative group were bigger than that in the control at the end of 1st,3rd and 6th month,and significant differences were found between neighboring evaluations in rehabilitative group.The motor FCA of the control group exhibited significant differences only at the end of 1st and 3rd month comparing with previous assessment.The increments of the motor FCA of the rehabilitative group were bigger that that of the control,and there were significant differences between the neighboring evaluations in rehabilitative group.The cognitive FCA of the control group didn't increase obviously,and no significant differences were found between the neighboring assessments. The cognitive FCA of the rehabilitative group exhibited improving tendency and the increments were bigger than that of the control at 1st,3rd and 6th month,but significant difference was only found at 1st month comparing with the recruitment in the rehabilitative group.Conclusion;The study indicated that the standardized three-stage rehabilitation treatment could increase the comprehensive functional abilities in ischemic stroke patients.PartⅣ;Effects of early-stage exercise training on expression of angiopoietins in rats with ischemic strokeObjective;The effects of early-stage exercise training on the neuro-function,the infarct volume and the protein and gene expression of angiopoietins and their receptor were studied in order to explore the mechanism of the functional recovery in rats with ischemic stroke.Methods; Adult male Sprague Dawley rats(n=36)were randomly divided into exercise group,non-exercise group and SHAM group,12 rats in each group.Right middle cerebral artery occlusion was performed using Longa method.24 hours after the operation,treadmill exercise was given to the exercise group rats,30 minutes each day for 2 weeks.The other two groups were housed as non-exercised control,or housed as SHAM control for 2 weeks seperately. Scores of neurological behavior and infarct volume were evaluated,and Real-time reverse transcriptase-polymerase chain reaction was applied to test the expression of angiopoietin-1,angiopoietin-2 and Tie-2.Results;Exercise significantly(p＜0.01)increased the scores of neurological behavior,proteins and mRNA expression of angiopoietin-1 and Tie-2 at the end of 2 weeks.In two-week-exercising rats subjected to 1-h MCA occlusion,infarct volume were significantly reduced.Conclusion;This study indicates that exercise reduces brain injury in rats with ischemic stroke.The reduced damage is associated with angiogenesis,possibly induced by angiogenic factors following exercise. Physical exercise up-regulates protein and mRNA levels of the angiopoietin/Tie-2 pathway.PartⅤ;Experimental study of the optimal time of exercise intervention after ischemic strokeObjective;The effects of exercise intervention at different time points after local ischemic brain injury on the neuro-function in rats were studied in order to probe the optimal opportunity for rehabilitation training for ischemic stroke. Methods;18 adult male Sprague-Dawley rats were randomly divided into early training group,late training group and no training group,6 rats in each group.Right middle cerebral artery occlusion was performed using Longa method.Early training and late training groups started 1 week's treadmill exercise 24 hours or 1 week post the MCAO operation separately,the scores of neurological behavior was evaluated and infart volume was measured morphometrically.Results;The scores of neurological behavior of the early training group were higher than those of the no training group,and the infarct volume was also smaller than that of the no training group.However,there were no differences in the neurological behavior scores and the infarct volume between the late training and no training groups.Conclusions;Early stage exercise intervention may be beneficial to the neuro-function recovery for the ischemic brain stroke in rats.