A Study On The Preferred Regimen Of Early Activity In Patients With Acute Ischemic Stroke

ObjectiveIn this study,from the perspective of the implementation of early mobilization as the entry point,after screening out the factors affecting the implementation of early mobilization,the orthogonal design test method is adopted to explore the optimal program of early mobilization for acute ichemic stroke patients,so as to achieve the purpose of promoting the safety and effectiveness of early mobilization.MethodThe three factors affecting early mobilization(activity intensity,activity frequency,duration time of each activity)and the corresponding three levels were grouped according to the orthogonal design L₉(3³).Sixty-three patients with acute ichemic stroke who were hospitalized in the Department of Neurology of a Grade A hospital in Nanjing were conveniently chosen as the paticipants,and randomly assigned to 9 different early activity programs for rehabilitation training.Researchers used different assessment scales to evaluate patients when they were admitted,discharged,1 month after discharge,and 3 months after discharge.Scales included National Institutes of Health Stroke Scale,Barthel Index,modified Rankin scale,Fatigue Severity Scale,Irritability Depression and Anxiety Scale,Stroke Self-Efficacy Questionnaire,Stroke-Specific Quality of Life Scale,and Impact on Participation and Autonomy Questionnaire to assess the patient's neurological deficit,activities of daily living,fatigue after stroke,negative emotions and other physical and mental states,as well as the overall living conditions such as rehabilitation self-efficacy,social participation and quality of life after discharge.Orthogonal design analysis of variance and range analysis were used.We evaluated the influence of 9groups of different early activity programs on all evaluation indexes of acute ichemic stroke patients,and finally selected the optimal early mobilization program among various intervention factors.Since the initiation time of mobilization might have an impact on the outcome of patients,the initiation time of mobilization of enrolled patients was classified according to 3 levels and included in the data processing.ResultsOf the 63 acute ichemic stroke patients,a total of 57 patients finally completed the study,including 36 males and 21 females.The initiation time,intensity,and frequency of mobilization were the main factors(all P<0.05),and the duration of each activity was a secondary factor(P>0.05).Considering all influencing factors,the optimal level of the early mobilization program of acute ichemic stroke patients was an initiation time:24-48 h after stroke;intensity:bed and chair transfer,sitting out of bed,standing and walking or climbing stairs when mobility permitted;frequency:2-3times/day;duration of each mobilization:determined according to the actual situation of the patient.ConclusionsAcute ichemic stroke patients may benefit from high-intensity rehabilitation exercises 2-3 times/day within 24-48 hours after the onset of stroke.Applying the optimized program to implement early activities for acute ichemic stroke patients can effectively reduce the degree of disability,improve self-care ability,rehabilitation self-efficacy,quality of life,social participation and reduce post-stroke fatigue.