AIM: To observe the effects of the early intervention of occupational therapy plus exercise therapy on the activities of daily life (ADL) in stroke patients, and compare the effects with those of exercise therapy only. METHODS: Totally 120 inpatients, who were hospitalized in the Henan Project Technological Research Center of Stroke of Traditional Chinese Medicine between March 2003 and June 2005, participated in the study, the duration from the attack to the beginning of rehabilitation therapy was (6.6 +/- 5.0) days. The patients were randomly divided into exercise therapy group (n = 40) and exercise plus occupational therapy group (n = 120). All the patients were given the exercise therapy of keeping good posture and position of limbs, passive activity of joint, bridge movement, neuromuscular facilitation, balance of sitting positive, balance of standing-position and gait training. 40 to 50 minutes per day for an average course of 7 weeks. Besides, the patients in the exercise plus occupational therapy group also participated in the ADL relearning training, selective topic therapy was mainly given at convalescent period, other trainings were the reinforced training of refined activity of ipsilateral upper limb, training by means of self-help tool and assisted tool, replacement and compensation training of the unaffected limb, 40 to 50 minutes per day. The first evaluation was performed at 24 hours after the beginning of rehabilitation therapy, the motor function was assessed with Fugl-Meyer score for motor function of limbs, and ADL was evaluated with Barthel Index, and then the patients were evaluated once every two weeks. RESULTS: According to intention-to -treat analysis, all the 160 cases entered the inalysis of results. (1) Fugl-Meyer scores: the scores at 2, 4, 6 and 8 weeks after therapy were higher in the exercise+occupational therapy group than in the exercise therapy group (p < 0.01). (2) Barthel Index: the Barthel Index at 2, 4, 6 and 8 weeks after therapy were higher in the exercise+occupational therapy group than in the exercise therapy group (p < 0.01). (3) Under the same motor function (the game Fugl-Meyer score), the ADL score in the exercise+occupational therapy group was higher than that in the exercise therapy group, and it was the most significantly different when the Fugl-Meyer score was 45 to 60 points (p < 0.01). CONCLUSION: Early intervention of occupational therapy plus exercise therapy can effectively improve the ADL and motor ability of stroke patients, and the rehabilitative effects are better than those of the exercise therapy only.

Full text (sometimes free) may be available at these link(s):      help

• PDF locator
• publisher