| Objective:on the basis of discussing the influence of gender,age,stroke type,course of disease,lesion location,motor function and cognition on the prognosis of aphasia rehabilitation,this study uses Beijing Zhongkang aphasia evaluation scale and different measurement of motor function scale to evaluate the effect of aphasia rehabilitation by traditional rehabilitation and posture controlled dynamic rehabilitation intervention of limbs The purpose is to provide a new idea for the clinical rehabilitation of aphasia patients after strokeMethods : from January 2018 to March 2019,163 stroke inpatients in the Department of kinesitherapy of Shaanxi rehabilitation hospital were selected as the research objects to collect basic data such as gender,age,lesion location,motor function,etc.firstly,spss23.0 software was used to conduct person correlation analysis and multiple regression analysis on various factors affecting speech function of aphasia patients;secondly,compliance was selected to be included in the study Standard 40 stroke patients(course of disease within 1 year)were randomly divided into 4 groups(10 in each group): the control group received traditional rehabilitation intervention,the experimental group received dynamic training intervention of upper limb under posture control(upper limb group for short),dynamic training intervention of lower limb under posture control(lower limb group for short),dynamic training of upper and lower limb under posture control(upper limb group for short)Training intervention(referred to as: upper and lower limb group).The intervention period of each group was 8 weeks.Before intervention,4 weeks after intervention and 8 weeks after intervention,Beijing Zhongkang aphasia examination scale and different measurement of motor function scale were used to evaluate the speech function of patients and the upper and lower extremity motor function,walking ability,balance function,ADL,etc.which affected the posture control,and the two factors repeated measurement analysis of variance was used for the collected data.Results:(1)Analysis of the correlation between the factors and the speech function of aphasiaThe results of person correlation analysis showed that the speech function scores of aphasia patients were correlated with the lesion site,cognition,Fugl Meyer upper limb,Fugl Meyer lower limb,stroke type,ADL,pass,Berg,risk factors and occupational category,and the R values were-0.546,0.481,0.339,0.289,-0.270,0.218,-0.199,0.23,0.187,-0.173.(2)The comparative results before and after the intervention of motor function of each category in each groupThe scores of Brunnstrom upper extremity,Brunnstrom hand,Brunnstrom lower extremity,Fugl Meyer upper extremity,Fugl Meyer lower extremity,Fugl Meyer lower extremity,Fugl Meyer balance,posture control and daily living ability were significantly improved after 4 weeks of intervention compared with those before intervention(P < 0.05).There was no significant difference in walking function between the upper limb group and the pre intervention group.There was no statistical significance in the upper and lower extremity groups after 4 weeks of Fugl Meyer balance intervention compared with that before intervention(P > 0.05),and there was no statistical significance in the control group after 4 weeks of Fugl Meyer upper extremity intervention compared with that before intervention(P > 0.05).After 8weeks of intervention,the scores of the upper limb group,the lower limb group or the upper limb group were significantly higher than before(P < 0.05).After 8 weeks of intervention,the scores of the upper limb group,the hand group,the lower limb group,the Fugl Meyer upper limb group,the Fugl Meyer lower limb group,the walking function,the posture control and the ability of daily life were significantly higher than before(P > 0.05).Comparison of scores of upper limb group,lower limb group or upper limb group after 8 weeks of intervention and 4 weeks after intervention:Brunnstrom upper limb Brunnstrom hand,Brunnstrom lower limb,Fugl Meyer upper limb,Fugl Meyer lower limb,Fugl Meyer balance,walking function,posture control and daily life ability were all significantly improved(P < 0.05).There was no statistical significance in Fugl Meyer balance in the upper limb group and Fugl Meyer upper limb in the control group(P > 0.05).Compared with the control group,the effect of Fugl Meyer’s upper limb motor function score in the upper and lower limb intervention group was better than that in the control group(P < 0.05)at 8 weeks of intervention,and the difference of Fugl Meyer’s lower limb motor function score between the lower limb group and the upper and lower limb group was significant(P < 0.05).After 4 or 8 weeks of intervention,Fugl Meyer’s balance between the upper and lower limb group and the lower limb group was significant(P < 0.05),and the walking function between the upper and lower limb group was significant(P < 0.05)There was difference between the two groups(P < 0.05).(3)A comparative study of speech function before and after intervention in each groupThe results showed that there were significant differences between the upper limb group after 8 weeks of treatment and before intervention(P < 0.05),among which there were significant differences between the upper limb group after 8 weeks of intervention and 4 weeks of intervention(P < 0.05).There was no statistical significance in reading nouns,reading verbs,reading sentences,reading nouns,reading verbs and reading sentences(P > 0.05).There was a significant difference between the lower extremity group and the voice group(P < 0.05).There weresignificant differences in the items of listening comprehension verbs,listening comprehension nouns,listening comprehension sentences,execution,repetition nouns,repetition verbs,repetition sentences,saying nouns,saying verbs,reading nouns aloud,reading verbs aloud,reading sentences aloud,reading nouns and reading verbs between the upper and lower limb groups after 8 weeks and before the intervention(P< 0.05).There were significant differences in the items of listening comprehension verbs,listening comprehension nouns,listening comprehension sentences,executing,retelling nouns,retelling verbs,retelling sentences,speaking nouns,speaking reading nouns,speaking reading verbs,speaking reading verbs,speaking reading sentences,reading nouns and reading verbs between 8 weeks and 4 weeks after intervention(P <0.05).There was significant difference between the control group and the control group(P < 0.05).Compared with the speech function group,there were differences in terms of listening and understanding nouns,listening and understanding verbs,listening and understanding verbal command execution items in the upper and lower limb groups compared with the control group(P < 0.05).There were differences in terms of listening and understanding verbal command execution,speaking verbs,voice reading categories in the lower limb group compared with the control group.There was no difference between the other groups,and there was no statistical significance in reading.Conclusion:(1)The speech function of aphasia patients with stroke is related to the location of lesion,cognition,Fugl Meyer upper extremity,Fugl Meyer lower extremity,stroke type,ADL,posture control,balance,risk factors and occupational category.(2)Dynamic rehabilitation of upper and lower limbs under postural control and traditional rehabilitation therapy have rehabilitation effects on stroke aphasia patients within one year,mainly in terms of listening to understand nouns,verbs and oral orders.The dynamic training effect of the upper extremity is better than that of the lower extremity,and the dynamic training effect of the upper extremity is better than that of the lower extremity.(3)Different intervention cycles have different effects on the rehabilitation of stroke patients within one year,8 weeks is better than 4 weeks,and the rehabilitation effect is based on the traditional rehabilitation under the control of posture plus dynamic training of lower limbs. |
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