对不同年龄中重型创伤性颅脑损伤（TBI）患者进行多维度康复功能评估，分析其运动功能、肌张力、关节活动度（ROM）、平衡及语言认知等方面的差异性，为按年龄分层实施康复干预提供参考。

回顾性纳入什邡市人民医院神经外科及四川大学华西医院神经外科自2014年1月至2023年12月收治的中重型TBI患者1200例，按年龄分为老年组（60~80岁，160例）、中年组（45~59岁，680例）和青年组（<45岁，360例）。在进入康复初始阶段及康复结束时，分别采用Brunnstrom运动评价、Ashworth分级评价、ROM评价、Bobath评价及语言认知障碍评定进行多维度康复功能评估。依据康复结束时各量表的变化程度，对比不同年龄组各维度功能评估结果及其差异。

Brunnstrom运动评定：3组患者康复后运动功能均较基线明显改善，且青年组、中年组的良好率高于老年组，差异有统计学意义（P<0.05）。Ashworth分级：老年组患者的肌肉痉挛恢复良好率低于中、青年组，差异均有统计学意义（P<0.05）。ROM评定：3组患者的ROM均有恢复，但老年组恢复良好率低于中、青年组，差异均有统计学意义（P<0.05）。Bobath评定：3组患者的坐位、站立位平衡功能均较初始明显改善，终末平衡状态良好率组间比较差异无统计学意义（P>0.05）。语言与认知功能：老年组、中年组和青年组的语言认知功能7~17分恢复至18~28分占比分别为87.5%、95.5%和97.2%，3组占比两两比较，差异均有统计学意义（P<0.05）。

多维度康复功能评估能够全面反映中重型TBI患者的康复情况，不同年龄组之间存在明显差异，其中老年患者在痉挛缓解和关节活动恢复方面相对不足，中青年患者在运动及语言认知功能恢复方面优势更为突出。临床应重视多维度康复功能评估在不同年龄患者差异性分析中的作用，根据评估结果按年龄分层制定个体化康复策略。

To perform multidimensional rehabilitation functional assessment in patients of different ages with moderate-to-severe traumatic brain injury (TBI), analyze differences in motor function, muscle tone, range of motion (ROM), balance, and language/cognitive function, and provide a reference for age-stratified rehabilitation interventions.

A total of 1 200 patients with moderate-to-severe TBI admitted to the Neurosurgery Department of Shifang People's Hospital and the Neurosurgery Department of West China Hospital, Sichuan University, from January 2014 to December 2023 were retrospectively enrolled. According to age, patients were divided into an elderly group (60-80 years, n=160), a middle-aged group (45-59 years, n=680), and a young group (<45 years, n=360). Multidimensional rehabilitation functional assessments were performed at the beginning and at the end of the rehabilitation program, including Brunnstrom motor assessment, Ashworth scale, ROM evaluation, Bobath assessment, and language/cognitive impairment assessment. Based on the degree of change in each scale at the end of rehabilitation, functional assessment results and differences across various dimensions were compared among the different age groups.

Brunnstrom motor assessment showed that motor function improved significantly from baseline in all three groups after rehabilitation, with higher rates of good recovery in the young and middle-aged groups than in the elderly group, while the proportion of poor recovery was highest in the elderly group (P<0.05). Ashworth evaluation showed the favorable recovery rate for muscle spasticity in the elderly group was lower than that in both the middle-aged and young groups, with statistically significant differences (P<0.05). ROM assessment: All three groups achieved ROM recovery; the favorable recovery rate was significantly lower in the elderly group than in the middle-aged and young groups (P<0.05). Bobath evaluation showed all three groups demonstrated significant improvements in sitting and standing balance functions compared to initial assessments. However, no statistically significant differences were observed in the favorable balance status rates among the groups at the end of rehabilitation (P>0.05). In terms of language and cognition, the proportions of patients whose language-cognitive function scores improved from the 7-17 range to the 18-28 range were 87.5% in the elderly group, 95.5% in the middle-aged group, and 97.2% in the young group. Pairwise comparisons among these three age groups all demonstrated statistically significant differences (P<0.05).

Multidimensional rehabilitation functional assessment comprehensively reflects the rehabilitation status of moderate-to-severe TBI patients, revealing significant differences across age groups. Specifically, elderly patients show relatively insufficient recovery in spasticity relief and joint ROM restoration, while middle-aged and young patients demonstrate more prominent advantages in motor function and language-cognitive recovery. Clinical practice should emphasize the role of differential analysis in multidimensional assessments across age groups, enabling the development of age-stratified, individualized rehabilitation strategies based on assessment outcomes.