| Object: To investigate the effect of the second-level prevention and rehabilitation care in the community after stroke, which will provide the evidence to popularize rehabilitation care in the community.Method: Some community residents in Jilin Province were divided into treatment group and control group randomly .One hundred were treatment group and another one hundred were control group in two hundred patients in acute stage(onset within 3 months) and convalescence stage (onset from 3 months to one and a half year).There are 50 cases in acute stage including 35 patients with cerebral infarction and 15 patients with brain hemorrhage ,and the same situation to 50 cases in convalescence stage in 100 cases. Every patient was followed up for five months, and evaluated for three time. The scores were made by the same person. The evaluated time was the first time when selected(V1),the second time on the second month at(V2),the third time on the fifth month. The standard is clinic nerve function injury assessment, Barthel index, Functional comprehensive assessment (FCA) .The blood pressure ,heart rate ,blood sugar , blood-fat, blood viscosity of all cases were observed at home. The knowledge of prevention and cure of cerebral apoplexy, distributing the manual of stroke habilitation. The rehabilitation measure were laid out according to the different patients in treatment group. The doctor of community direct the functional exercise, mainly including ADL drill, OT therapy, PT treatment. Once a week at the beginning, one time per two weeks in the later two months, then once a month in the last 2 months. The patients did not do rehabilitation training in control group. The data of statistical treatment was dealt by SPSS 12.0 Data are expressed as mean±SD. Continuous variables were analyzed according to Student's t test. Adopting 2 , test. rank sum test, X2 analysis.Results:1,The comparison of cerebral infarction patients and brain hemorrhage patients between treatment group and control group on V1 was no difference(P>0.05).Hand function of brain hemorrhage patients in control group was better that in treatment group. There was no difference in other evaluation index(P>0.05). FCA scores of cerebral infarction, shoulder and brachial locomotion, the ability of walking on V2 differed from V1(P<0.05). Others were no different(P>0.05). FCA scores of cerebral infarction, shoulder and brachial locomotion, the ability of walking, Barthel and FCA scores on V3 differed from V1(P<0.05). Others were no different(P>0.05).2,The patients in acute stage and convalescence stage were compared. The shoulder and brachial locomotion and hand motion of patients in acute stage were better. (P<0.05).The Barthelscores of patients in convalescence stage in treatment group were better than that in control group. The ability of walking and FCA scores were compared within the group(P<0.05).The results showed that the scores of the lower limbs motion were higher(P<0.01). There was difference in Barthel in convalescence stage between treatment group and control group on V2(P<0.05).There was no difference between treatment group and control group on V3(P>0.05).The difference of shoulder and brachial locomotion was significant within the group (P<0.05),the scores of the lower limbs motion were higher dramatically(P<0.01).There was difference in FCA in treatment group and control group both endoteam and interclass. (P<0.05).There was difference in Barthel between treatment group and control group. (P<0.01).3,The comparison of the patients in acute stage and convalescence stage between treatment group and control group: The difference of all scores was significant in acute stage and convalescence stage in treatment group on V1(P<0.01).The scores in convalescence stage were high. There was no difference in acute stage and convalescence stage in control group. The recovery of shoulder and brachial locomotion, hand motion and the lower limbs motion was so soon in acute in treatment group on V2.There was remarkable difference within group(P<0.01).The scores of Barthel,FCA were different between groups(P<0.05).There was difference in the ability of walking in control group in acute stage and convalescence stage(P<0.05).The comparison in treatment group between acute stage and convalescence stage showed that there was significant difference in the scores of shoulder and brachial locomotion, the lower limbs motion, the ability of walking, Barthel,FCA within. (P<0.01),The hand motion was different. (P<0.05) The scores of FCA in control group in acute stage were higher than in the convalescence stage (P<0.05).Others were no difference(P>0.05).Conclusion: 1.The scores of the patients with cerebral infarction was improved after rehabilitation care. It was improved that the condition of shoulder and brachial locomotion , hand function, the ability of walking and the capacity of routine living and the scores of combination function of patients with cerebral hemorrhage in treatment group. It showed that the recovery of cerebral hemorrhage is better than cerebral infarction .2. It was improved that the condition of shoulder and brachial locomotion , hand function, the ability of walking and the capacity of routine living and the scores of combination function of patients with cerebral hemorrhage in acute stage in treatment group. It stated that it is important for patients in acute stage to rehabilitation care. 3.The living ability and combination function of patients in convalescence stage was improved, and the rehabilitation care is still inevitable to improve the living.4.In control group, the ability of walking and combination function were improved during natural recovery period under no rehabilitation. But other functions were still stayed at the period of 5months before elected, especially there is no change for convalescent .This condition always leads to the occurrence of abusage syndrome without regularity direction. These factors and abnormal mode may exist for a long time, which hazard the patients health seriously. It stated that the recovery state of rehabilitation care is more important,5.The community rehabilitation care should be advocated because community second-level prevention after shock can improve the situation of motion and routine living of the patients with cerebral infarction.6. This rehabilitation care therapeutic regimen accord with the condition of China and provide the evidence for the government developing and constructing community hygiene service.
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