| [Objective] To investigate the safety of very early mobilization(out-of-bed and frequent mobilization within 24 hours after onset stroke) in acute ischemic stroke, to observe the effect of rehabilitation in the acute ischemic stroke patients.On the basis further to explore the optimal activity time and contents in patients with acute ischemic stoke.[Method] It was prospective randomized controlled trial, select the acute ischemic stroke patients admitted in the neurology department of Nanjing Drum Towel hospital from January 2014 to January 2015. Computer generated random number, odd number were experimental group, and the even number were control group, blinded assessment of outcomes. Divide into delayed mobilization group (According to the guidelines and routine care to perform diagnosis and treatment and nursing, do not emphasize out-of-bed mobilization, start to out-of-bed mobilization after 24 hours stroke onset.) and very early mobilization group (According to the guidelines and routine care to perform diagnosis and treatment and nursing, emphasize out-of-bed and frequent mobilization within 24 hours after stroke onset.).Using National Institute of Health Stroke Scale (NIHSS) to evaluate the degree of nervous functional defects of acute ischemic stroke patients, Barthel Index (Bl) to measure activities of daily living, applying Self-Rating Depression Scale (SDS), Chronic Disease Self-efficacy Scale and Stroke Impact Scale (SIS) respectively to measure the level of depression self-efficacy and quality of life of patients with acute ischemic stroke.[Result]1. Compare with the general demographic information of the two group:covered with gender、age、education、 occupation、marriage, family per capita income, medical payment、companion、frequency of visit、prior history of stroke admission time after stroke、area of infarction、co-morbidities、stroke risk factors, consciousness after stroke and NIHSS、BI、SDS、Self-efficacy、SIS at admission, showed no significant difference (P>0.05)2. Compare with the time of out-of-bed, the time of physical therapist interfere, frequency of out-of-bed per day, overall time of out-of-bed activities per day, VEM group were earlier and more mobilization after stoke onset, differences are statistically significant (P<0.05); The companion of two groups are nurses or physical therapists, P=0.21, no significant difference.3. The NIHSS at 14 days after stroke or patients discharged of two groups, VEM group were lower than delay mobilization group, differences are statistically significant (P=0.001); The Comparison of the average length of stay with the two groups, VEM group were shorter, differences are statistically significant (P=0.017);Compare with BI、SDS、Self-efficacy and SIS at 14 days after stroke oneset or discharged and 3 months after stroke onset of two groups,VEM group were better than delay mobilization group, differences are statistically significant (P<0.05)4. Progressive of nervous functional defects、cranial hemorrhage after infarct between the two groups, differences are no statistically significant (P>0.05); Compare with the complications of two groups, VEM group were inferior to delay mobilization group, differences are statistically significant (P<0.05).[Conclusion] Very early mobilization had been applied in early rehabilition of acute ischemic stroke patients were safety, might reduce the severe complication by long-term bed rest after acute ischemic stroke occurred, might improve the extent of nervous functional defects recovered, promote the activities of daily living restored, might increase self-efficacy by successful practice and "mastery experience " of out-of-bed activities, might decrease the incidence of depression and enhanced the quality of life. |
PDF Full Text Request