Effect of post-stroke sensory disorders on the recovery processes of motor function and activity of

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BACKGROUND: In the rehabilitation of stroke patients, clinicians usually concentrate on motor problems, such as spasm of limbs and restriction of joint motion, while sensory and perceptive problems are almost always neglected, although they are just as important. One such area is the sensory disorder. OBJECTIVE: To evaluate the motor function and activities of daily living in stroke patients with and without sensory disorders after treatment of integrated western and Chinese medicine. DESIGN: A non-randomized synchronically controlled trial. SETTING: First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine. PARTICIPANTS: Totally 500 stroke inpatients were selected from the Department of Acupuncture and Massage, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine from January 2003 to December 2004. They all had suffered from stroke in the last 4 weeks and accompanied by sensory disorder of the ipsilateral limb to different severity. The patients were all accorded with the Diagnostic and Efficacy Evaluative Standards for Stroke (in trial) set by the Encephalopathy Emergency Assistant Group, the State Administration of Traditional Chinese Medicine in 1995, and they were diagnosed by imaging examination. The patients were stratified into sensory disorder group (n =220) and normal sense group (n =280). Informed consent for the detected items and therapeutic program was obtained from the relatives of all the participants. The study was approved by the hospital ethical committee. METHODS: All the patients were treated with acupuncture of Xing Nao Kai Qiao for restoring consciousness and inducing resuscitation, assisted by traditional Chinese medicine and western medicine specific to corresponding symptoms. The therapeutic principles were restoring consciousness and inducing resuscitation, nourishing liver and kidney, and dredging meridian. In addition, the patients were given western medical treatments for decreasing intracranial pressure, thrombolysis, reducing blood viscosity, anticoagulation, anti-arteriosclerosis, ameliorating microcirculation, also administrated with activator for nerve cells. MAIN OUTCOME MEASURES: ① The severity of motor function deficit was evaluated using clinical neurological deficit score for stroke patients set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995; ② The activities of daily living was evaluated with Barthel Index, the higher the score, the better the independence, and the less the dependence. RESULTS: All the 500 stroke patients were involved in the final analysis of results. ① The neurological deficit scores before treatment had no significant difference between the two groups (P > 0.05), but the scores after treatment were significantly decreased as compared with those before treatment in both groups (t =6.59, 12.43, P < 0.01). The neurological deficit score after treatment in the normal sense group was significantly lower than that in the sensory disorder group (t =1.63, P < 0.05). ② The scores of activities of daily living after treatment were significantly increased as compared with those before treatment in both groups (t =16.03, 25.10, P < 0.01). The scores of activities of daily living in the normal sense group were higher than those in the sensory disorder group both before and after treatment (t =6.07, 14.26, P < 0.05). CONCLUSION: Sensory disorders have obvious negative effects on the recovery of motor function and activities of daily living of stroke patients. BACKGROUND: In the rehabilitation of stroke patients, clinicians usually concentrate on motor problems, such as spasm of limbs and restriction of joint motion, while sensory and perceptive problems are almost always neglected, although they are just as important. One such area is the sensory OBJECTIVE: To evaluate the motor function and activities of daily living in stroke patients with and without sensory disorders after treatment of integrated western and Chinese medicine. DESIGN: A non-randomized synchronized controlled trial. SETTING: First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine. PARTICIPANTS: Totally 500 stroke inpatients were selected from the Department of Acupuncture and Massage, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine from January 2003 to December 2004. They all had suffered from stroke in the last 4 weeks and accompanied by sensory disorder of the ipsilateral limb to different severity. The p atients were all accorded with the Diagnostic and Efficacy Evaluative Standards for Stroke (in trial) set by the Encephalopathy Emergency Assistant Group, the State Administration of Traditional Chinese Medicine in 1995, and they were diagnosed by imaging examination. The patients were stratified into sensory disorder METHODS: All the patients (n = 220) and normal sense group (n = 280). Informed consent for the detected items and therapeutic program was obtained from the relatives of all the participants. The study was approved by the hospital ethical committee. METHODS: All the patients the treated principles were restoring consciousness and inducing resuscitation, nourishing liver and kidney, and dredging meridian. , the patient were given western medical treatments for decreasing intracranial pressure, thrombolysis, reducing blood viscosity, anticoagulation, anti-arteriosclerosis, ameliorating microcirculation, also administrated with activator for nerve cells. MAIN OUTCOME MEASURES: ① The severity of motor function deficit was evaluated using clinical neurological deficit score for stroke patients set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995; ② The activities of daily living was evaluated with Barthel Index, the higher the score, the better the independence, and the less the dependence. RESULTS: All the 500 stroke patients were involved in the final analysis of results. ① The neurological deficit scores before treatment had no significant difference between the two groups (P> 0.05), but the scores after treatment were significantly decreased as compared with those before treatment in both groups (t = 6.59, 12.43, P <0.01). The neurological deficit score after treatment in the normal sense group was significantly lower than th at the sensory disorder group (t = 1.63, P <0.05). ② The scores of activities of daily living after treatment were significantly increased as compared with those before treatment in both groups (t = 16.03, 25.10, P <0.01). The scores of activities of daily living in the normal sense group were higher than those in the sensory disorder group both before and after treatment (t = 6.07, 14.26, P <0.05). CONCLUSION: Sensory disorders have obvious negative effects on the recovery of motor function and activities of daily living of stroke patients.
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