Effect of massage combined with very early mobilization on rehabilitation in patients with acute ischemic stroke

doi:10.3877/cma.j.issn.2095-123X.2022.01.005

Abstract

Abstract:

Objective

To explore the effects of massage combined with very early exercise (VEM) on the rehabilitation effect, brain-derived neurotrophic factor (BDNF) and motor ability of patients with acute ischemic stroke (AIS).

Methods

One hundred and ten patients with AIS within 24 h, admitted to Institute of Nerve Trauma and Repair, Characteristic Medical Center of PAP from January 2019 to June 2020, were randomly divided into 2 groups, with 55 cases in each group. The control group started the first VEM within 24 h (including self-sitting, standing or walking out of bed), once a day for 10-30 min each time; On the basis of the control group, the observation group started the first massage treatment within 24 h, each time for 20 min; both groups were treated for 2 weeks. Observe and compare the serum BDNF content, National Institute of Health stroke scale (NIHSS) score, modified Barthel index (MBI) score, (upper and lower limbs) Fugl-Meyer motor assessment (FMA), Berg balance scale (BBS) score and Wisconsin gait scale (WGS) score at admission, 2 weeks, 1 and 3 months after stroke; and the modifiedRankin scale score was observed at 1 and 3 months.

Results

After rehabilitation, the scores of NIHSS, MBI, upper and lower limb FMA, BBS and WGS were significantly improved (P<0.05), and the content of serum BDNF significantly increased (P<0.05); the NIHSS and upper limb FMA scores of the observation group were significantly better than the control group at 1 and 3 months (P<0.05); at 2 weeks, 1 and 3 months, the MBI, lower limb FMA, BBS and WGS scores of the observation group were significantly better than the control group (P<0.05), and serum BDNF content was significantly higher than the control group (P<0.05); the outcome of the observation group was significantly better than the control group at 3 months (P<0.05).

Conclusion

Massage combined with VEM can better improve the rehabilitation effect, the expression of BDNF and recovery of exercise capacity of AIS patients, and increase long-term good outcome.

Key words: Massage, Very early mobilization, Ischemic stroke, Rehabilitation effect, Brain-derived neurotrophic factor, Exercise capacity

Haibo Yu, Di Yu, Bin Su, Yisha Guo, Huancheng Wu, Junfeng Bi. Effect of massage combined with very early mobilization on rehabilitation in patients with acute ischemic stroke[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(01): 32-37.

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References 17

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项目		对照组（n=55）	观察组（n=55）	χ²/t值	P值
男性[例（%）]		33（60.00）	30（54.55）	0.334	0.563
年龄（岁，Mean±SD）		63.09±6.76	62.36±6.60	0.595	0.533
吸烟[例（%）]		21（38.18）	18（32.73）	0.358	0.550
发病时间（h，Mean±SD）		8.73±1.20	8.89±1.29	0.493	0.688
梗死部位[例（%）]				1.205	0.752
	基底节	21（38.18）	22（40.00）
	脑叶	24（43.64）	26（42.27）
	脑干	5（9.09）	4（7.27）
	小脑	5（9.09）	3（5.46）
入院NIHSS评分（分，Mean±SD）		14.27±1.27	14.00±1.09	1.210	0.229
既往病史[例（%）]				0.155	0.694
	高血压	41（74.55）	39（70.91）
	糖尿病	18（32.73）	20（36.36）
血脂指标（mmol/L）
	TC	7.01±0.86	6.64±1.76	1.374	0.172
	TG	2.69±0.91	3.04±1.16	1.733	0.086
	LDL-C	5.19±1.78	5.52±2.44	0.831	0.408
	HDL-C	2.55±0.95	2.80±1.13	1.272	0.206

项目		对照组（n=55）	观察组（n=55）	χ²/t值	P值
男性[例（%）]		33（60.00）	30（54.55）	0.334	0.563
年龄（岁，Mean±SD）		63.09±6.76	62.36±6.60	0.595	0.533
吸烟[例（%）]		21（38.18）	18（32.73）	0.358	0.550
发病时间（h，Mean±SD）		8.73±1.20	8.89±1.29	0.493	0.688
梗死部位[例（%）]				1.205	0.752
	基底节	21（38.18）	22（40.00）
	脑叶	24（43.64）	26（42.27）
	脑干	5（9.09）	4（7.27）
	小脑	5（9.09）	3（5.46）
入院NIHSS评分（分，Mean±SD）		14.27±1.27	14.00±1.09	1.210	0.229
既往病史[例（%）]				0.155	0.694
	高血压	41（74.55）	39（70.91）
	糖尿病	18（32.73）	20（36.36）
血脂指标（mmol/L）
	TC	7.01±0.86	6.64±1.76	1.374	0.172
	TG	2.69±0.91	3.04±1.16	1.733	0.086
	LDL-C	5.19±1.78	5.52±2.44	0.831	0.408
	HDL-C	2.55±0.95	2.80±1.13	1.272	0.206

时间	NIHSS评分		t值	P值	MBI评分		t值	P值
时间	对照组（n=55）	观察组（n=55）	t值	P值	对照组（n=55）	观察组（n=55）	t值	P值
入院时	14.27±1.27	14.00±1.09	1.617	0.106	42.29±2.28	41.36±3.28	1.119	0.264
发病后2周	9.04±0.88^a	8.82±0.96^a	1.294	0.197	62.02±5.63^a	63.13±5.13^a	2.093	0.037
发病后1个月	7.91±0.75^a	5.91±0.73^a	11.860	<0.001	76.82±5.88^a	84.91±6.03^a	8.031	<0.001
发病后3个月	6.33±0.51^a	4.50±0.63^a	10.890	<0.001	83.87±6.39^a	91.53±6.45^a	7.598	<0.001
F值	811.200	1271.000			655.300	900.600
P值	<0.001	<0.001			<0.001	<0.001

时间	NIHSS评分		t值	P值	MBI评分		t值	P值
时间	对照组（n=55）	观察组（n=55）	t值	P值	对照组（n=55）	观察组（n=55）	t值	P值
入院时	14.27±1.27	14.00±1.09	1.617	0.106	42.29±2.28	41.36±3.28	1.119	0.264
发病后2周	9.04±0.88^a	8.82±0.96^a	1.294	0.197	62.02±5.63^a	63.13±5.13^a	2.093	0.037
发病后1个月	7.91±0.75^a	5.91±0.73^a	11.860	<0.001	76.82±5.88^a	84.91±6.03^a	8.031	<0.001
发病后3个月	6.33±0.51^a	4.50±0.63^a	10.890	<0.001	83.87±6.39^a	91.53±6.45^a	7.598	<0.001
F值	811.200	1271.000			655.300	900.600
P值	<0.001	<0.001			<0.001	<0.001

时间	对照组（n=55）	观察组（n=55）	t值	P值
入院时	4.31±0.58	4.52±0.53	1.244	0.214
发病后2周	5.05±0.50^a	5.66±0.68^a	5.356	<0.001
发病后1个月	5.57±0.65^a	6.11±0.70^a	4.748	<0.001
发病后3个月	5.74±0.60^a	6.35±0.52^a	5.341	<0.001
F值	66.520	104.100
P值	<0.001	<0.001

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