RESUMO
Objective To compare the effect of mirror therapy (MT) supplemented by early rehabilitative intervention and acupunture therapy on recovery of hemiplegic limb function versus routine occupational training in post-stroke elderly patients.Methods Totally 120 acute-stroke elderly patients with limb paralysis were randomly divided into two groups:MT group and control group (n=60,each).All 120 patients received routine rehabilitative intervention and acupunture therapy except for 30 minutes mirror therapy daily as add-on therapy to the MT group,all patients were assessed with Chinese Stroke Scale(CSS) and the Barthel index(BI) before and after treatment 1 and 3 months.Results At the end of 1 and 3 months of treatment,CSS in the MT groups was (15.6±8.5)scores,(11.6±7.2)scores,ADL was (75.3±13.9)scores,(80.1±13.0)scores;CSS in the control group was (16.2±5.8)scores,(14.8±6.1)scores,ADL was (68.2±13.5)scores,(70.5±12.9)scores.Before treatment,CSSandADLwas (21.3±7.1)scores,(63.7±12.6)scoresin the MT group; (20.8 ± 7.6) scores,(61.7 ± 11.4) scores in the control group.There were significant differences in CSS and ADL between groups,except CSS after 1 month (t=1.40,2.38,-3.27,-3.47; P=0.166,0.019,0.001,0.001,respectively).After 3 months of treatment,CSS and ADL in the MT group had considerably outperformed those of the control group(t=2.40,-3.47,P＜0.05 or 0.01).Conclusions Mirror therapy is better than routine occupational training in improving the motor function of limbs and activities of daily living(ADL) ability 3 months after stroke,on the basis of early rehabilitative intervention and acupunture therapy.
RESUMO
Objective To investigate the safety and efficacy of intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rtPA)in patients with isolated penetrating artery territory infarct (IPAI).Methods Data of retrospectively collected clinical,laboratory,and radiological from 75 consecutive patients with acute ischemic stroke treated with intravenous rtPA therapy from June 2009 to April 2011.Etiological classification was carried out according to the Chinese Ischemic Stroke Classification of Subgroups(CISS).The rates of hemorrhagic transformation(HT)and clinical outcomes of patients were compared between IPAI group and non-IPAI group.Results All 75 patients with mean age of 67.4years and 25(33.3％)fenale,were treated with intravenous rtPA.Before treatment,their average score of the National Institutes of Health Stroke Scale(NIHSS)was 12.3 ± 6.4,and mean length of time from onset to treatment was 239.6 ±97.5 minutes.After thrombolytic therapy,the radiological HT was found in 24 patients(32％).Symptomatic intracraneal hemorrhage(ICH)occurred in 4 patients(5.3％).Of 22 (29.3％)patients with IPAI,only one experienced HT.Logistic regression analysis suggested that IPAI wasan individualized predictor used alone for determining the low risk of HT.In the patients with IPAI,82％ of them had an individual clinical outcome(mRS ＜ 2)one month after onset,and the neurological outcomes were better in patients with IPAI than those in patients with non-IPAI(P ＜ 0.01).Conclusions The risk of hemorrhagic complication was low and the clinical outcome was good in patients with isolated penetrating artery territory infarct after intravenous thrombolytic therapy with rtPA.Imaging diagnosis of IPAI might facilitate the treatment with rtPA in this cohort of patients.