中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2012, Vol. 7 ›› Issue (24): 1900-1905.

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

早期康复干预对手术夹闭或血管内栓塞治疗脑动脉瘤患者预后的影响

  

  • 收稿日期:2012-04-19 修回日期:2012-07-03 出版日期:2012-08-25 发布日期:2012-08-25

Outcomes of early physiotherapy in patients with cerebral aneurysms treated by surgical clipping or endovascular embolization

Arzu Guclu-Gunduz1, Sevil Bilgin2, Nezire Köse2, Hakan Oruckaptan3   

  1. 1 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
    2 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
    3 Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
  • Received:2012-04-19 Revised:2012-07-03 Online:2012-08-25 Published:2012-08-25
  • Contact: Arzu Guclu-Gunduz, Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Emniyet Mahallesi, Muammer Yasar Bostanci Cad. No.16 Besevler/Ankara, 06500 Turkey arzuguclu@hotmail.com
  • About author:Arzu Guclu-Gunduz☆, Ph.D., P.T., Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey

PDF

1109

Abstract:

Early physiotherapy was given to 124 patients with ruptured or unruptured cerebral aneurysms who were treated by surgical clipping or endovascular embolization. Patients were divided into four groups according to their Hunt and Hess grade at admission and aneurysm treatment modality: Group 1, Hunt and Hess grade ≤ II and surgical clipping; Group 2, Hunt and Hess grade ≤ II and endovascular embolization; Group 3, Hunt and Hess grade ≥ III and surgical clipping; Group 4, Hunt and Hess grade ≥ III and endovascular embolization. Level of consciousness was evaluated using the Glasgow Coma Scale, functional status using the Glasgow Outcome Scale, level of the mobility using the Mobility Scale for acute stroke patients, and independence in activities of daily living using the Barthel Index. After early physiotherapy, the level of consciousness and functional status improved significantly in Groups 1, 3, and 4; mobility improved significantly in all groups; and independence in activities of daily living improved significantly in Groups 1 and 3. At discharge, Groups 1 and 2 had better functional status than Groups 3 and 4. Level of consciousness, functional status, mobility and independence in activities of daily living improved after early physiotherapy. These findings suggest that early physiotherapy improved the prognosis of patients with cerebral aneurysms who were treated by surgical clipping or endovascular embolization. Patients with a worse clinical status at presentation had a poorer functional status at discharge. The outcome of physiotherapy was not affected by whether surgical clipping or endovascular embolization was chosen for treatment of the aneurysm.

Key words: cerebral aneurysm, Hunt and Hess grade, Glasgow Coma Scale, Glasgow Outcome Scale, functional status, surgical clipping, endovascular treatment, physiotherapy, neural regeneration