The progress of stroke rehabilitation_West China Medical Journal

Authors：

HUI Yanping , XI Yue ,  ZHANG Qiaojun

Department of Rehabilitation, the Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi 710004, P. R. China;

Corresponding author：

ZHANG Qiaojun, Email: zhangqj@mail.xjtu.edu.cn

Keywords：

Stroke; Dysfunction; Rehabilitation

DOI：

10.7507/1002-0179.201805118

Video：

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Stroke is one of the most health-threatening diseases in the world, with high incidence and high morbidity. Despite the development of stroke therapy and improved systems to recognize stroke symptoms and deliver care promptly, only a minority of patients with acute stroke receive thrombolytic therapy, and many of them remain with residual functional deficits. Thus, the need for effective stroke rehabilitation is likely to remain an essential part of the continuum of stroke care for the foreseeable future. This review summarizes and analyzes the results of literatures on stroke rehabilitation in recent years, briefly describes the rehabilitation techniques and progress in dyskinesia, speech barrier, dysphagia, emotional disorder and spasticity after stroke, to provide some references for the optimization of rehabilitation treatment.

Citation： HUI Yanping, XI Yue, ZHANG Qiaojun. The progress of stroke rehabilitation. West China Medical Journal, 2018, 33(10): 1295-1302. doi: 10.7507/1002-0179.201805118 Copy

1.	高一鹭, 王文志. 脑血管病流行病学研究进展. 中华神经科杂志, 2015, 48(4): 337-340.
2.	Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2016, 47(6): e98-e169.
3.	中华医学会神经病学分会神经康复学组, 中华医学会神经病学分会脑血管病学组, 卫生部脑卒中筛查与防治工程委员会办公室. 中国脑卒中康复治疗指南(2011 完全版). 中国康复理论与实践, 2012, 18(4): 301-318.
4.	邱卓英. 《国际功能、残疾和健康分类》研究总论. 中国康复理论与实践, 2003, 9(1): 2-5.
5.	邱卓英, 励建安, 吴弦光. ICF核心分类组合临床实践手册. 北京: 人民军医出版社, 2013.
6.	黄长琴, 钟艳. 脑卒中患者运动功能障碍康复治疗新进展. 检验医学与临床, 2017, 14(3): 449-451.
7.	Maraka S, Jiang Q, Jafari-Khouzani K, et al. Degree of corticospinal tract damage correlates with motor function after stroke. Ann Clin Transl Neurol, 2014, 1(11): 891-899.
8.	陈自谦, 张碧云, 倪萍, 等. 功能磁共振成像对脑缺血运动功能重组和康复的临床研究. 福州总医院学报, 2008, 15(3): 202-205, 246.
9.	宋婧源, 元小冬, 吕淑娟, 等. 体感诱发电位在脑卒中患者中应用价值的研究进展. 实用心脑肺血管病杂志, 2017, 25(12): 1-4.
10.	刘建民, 郑健. 诱发电位在脑卒中患者脑功能评估中的应用. 中国临床康复, 2004, 8(7): 1316-1318.
11.	Edwards MJ, Talelli P, Rothwell JC. Clinical applications of transcranial magnetic stimulation in patients with movement disorders. Lancet Neurol, 2008, 7(9): 827-840.
12.	Simonetta-Moreau M. Non-invasive brain stimulation (NIBS) and motor recovery after stroke. Ann Phys Rehabil Med, 2014, 57(8): 530-542.
13.	Rehme AK, Fink GR, von Cramon DY, et al. The role of the contralesional motor cortex for motor recovery in the early days after stroke assessed with longitudinal FMRI. Cereb Cortex, 2011, 21(4): 756-768.
14.	Hosomi K, Morris S, Sakamoto T, et al. Daily repetitive transcranial magnetic stimulation for poststroke upper limb paresis in the subacute period. J Stroke Cerebrovasc Dis, 2016, 25(7): 1655-1664.
15.	陆如蓝, 张成亮, 周先举. 重复经颅磁刺激在脑卒中康复中的临床应用进展. 医学综述, 2018, 24(6): 1097-1102.
16.	Smith MC, Stinear CM. Transcranial magnetic stimulation (TMS) in stroke: ready for clinical practice?. J Clin Neurosci, 2016, 31(9): 10-14.
17.	Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol, 2000, 527(Pt 3): 633-639.
18.	Hummel F, Cohen LG. Improvement of motor function with noninvasive cortical stimulation in a patient with chronic stroke. Neurorehabil Neural Repair, 2005, 19(1): 14-19.
19.	Nair DN, Renga V, Hamelin S, et al. Improving motor function in chronic stroke patients using simultaneous occupational therapy and tDCS. Stroke, 2008, 39(2): 542.
20.	Fregni F, Boggio PS, Mansur CG, et al. Transcranial direct current stimulation of the unaffected hemisphere in stroke patients. Neuroreport, 2005, 16(14): 1551-1555.
21.	励建安. 康复治疗技术新进展. 北京: 人民军医出版社, 2015.
22.	郑彭, 黄国志. 下肢康复机器人在脑卒中患者运动功能障碍中的应用进展. 中国康复医学杂志, 2017, 32(6): 716-719.
23.	Laver KE, George S, Thomas S, et al. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev, 2015, 43(2): CD008349.
24.	Darekar A, Mcfadyen BJ, Lamontagne A, et al. Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review. J Neuroeng Rehabil, 2015, 12(1): 46.
25.	瞿畅, 艾波, 郭爱松, 等. 基于 Kinect 的上肢康复训练系统开发与应用. 中国生物医学工程学报, 2015, 34(5): 607-612.
26.	汪洁, 吴东宇, 宋为群, 等. 双额叶在线经颅直流电刺激对失语症图命名的作用. 中国康复医学杂志, 2014, 29(1): 31-35.
27.	汪洁, 吴东宇, 袁英, 等. 应用在线经颅直流电刺激探查外侧裂后部对失语症恢复的作用. 中国康复医学杂志, 2011, 26(5): 106-410.
28.	张雅妮, 刘爱玲, 练涛. 经颅直流电刺激在脑卒中后失语症康复中的应用. 中西医结合心脑血管病杂志, 2018, 16(3): 308-310.
29.	王俊霞, 年莉. 中风后失语的中医治疗研究进展. 中医临床研究, 2012, 4(1): 114-116.
30.	中国吞咽障碍康复评估与治疗专家共识组. 中国吞咽障碍评估与治疗专家共识(2017 年版). 中华物理医学与康复杂志, 2018, 40(1): 1-10.
31.	Demir N, Serel Arslan S, Inal Ö, et al. Reliability and validity of the Turkish eating assessment tool (T-EAT-10). Dysphagia, 2016, 31(5): 644-649.
32.	李丽. 脑卒中的康复治疗及进展. 上海: 复旦大学, 2014.
33.	Lee JH, Kim SB, Lee KW, et al. Effect of repetitive transcranial magnetic stimulation according to the stimulation site in stroke patients with dysphagia. Ann Rehabil Med, 2015, 39(3): 432-439.
34.	Khedr EM, Abo-Elfetoh N, Rothwell JC. Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation. Acta Neurol Scand, 2009, 119(3): 155-161.
35.	Kim L, Chun MH, Kim BR, et al. Effect of repetitive transcranial magnetic stimulation on patients with brain injury and dysphagia. Ann Rehabil Med, 2011, 35(6): 765-771.
36.	Park JW, Oh JC, Lee JW, et al. The effect of 5 Hz high-frequency rTMS over contralesional pharyngeal motor cortex in post-stroke oropharyngeal dysphagia: a randomized controlled study. Neurogastroenterol Motil, 2013, 25(4): 324-e250.
37.	Park E, Kim MS, Chang WH, et al. Effects of bilateral repetitive transcranial magnetic stimulation on post-stroke dysphagia. Brain Stimul, 2017, 10(1): 75-82.
38.	Michou E, Raginis-Zborowska A, Watanabe M, et al. Repetitive transcranial magnetic stimulation: a novel approach for treating oropharyngeal dysphagia. Curr Gastroenterol Rep, 2016, 18(2): 10.
39.	窦祖林. 吞咽障碍评估与治疗. 2版. 北京: 人民卫生出版社, 2017.
40.	Gu SY, Chang MC. The effects of 10-Hz repetitive transcranial magnetic stimulation on depression in chronic stroke patients. Brain Stimul, 2017, 10(2): 270-274.
41.	Kedzior KK, Reitz SK. Short-term efficacy of repetitive transcranial magnetic stimulation (rTMS) in depression- reanalysis of data from meta-analyses up to 2010. BMC Psychology, 2014, 2(1): 39.
42.	Mcintyre A, Thompson S, Burhan A, et al. Repetitive transcranial magnetic stimulation for depression due to cerebrovascular disease: a systematic review. J Stroke Cerebrovasc Dis, 2016, 25(12): 2792-2800.
43.	Zheng MX, Hua XY, Feng JT, et al. Trial of contralateral seventh cervical nerve transfer for spastic arm paralysis. N Engl J Med, 2018, 378(1): 22-34.
44.	Madanat JP, Geraci S, Jajoo P, et al. Musculoskeletal pain as a novel complication after posterior tibial nerve block in stroke and traumatic brain injury patients. PM R, 2011, 3(5): 492-494.

1. 高一鹭, 王文志. 脑血管病流行病学研究进展. 中华神经科杂志, 2015, 48(4): 337-340.
2. Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2016, 47(6): e98-e169.
3. 中华医学会神经病学分会神经康复学组, 中华医学会神经病学分会脑血管病学组, 卫生部脑卒中筛查与防治工程委员会办公室. 中国脑卒中康复治疗指南(2011 完全版). 中国康复理论与实践, 2012, 18(4): 301-318.
4. 邱卓英. 《国际功能、残疾和健康分类》研究总论. 中国康复理论与实践, 2003, 9(1): 2-5.
5. 邱卓英, 励建安, 吴弦光. ICF核心分类组合临床实践手册. 北京: 人民军医出版社, 2013.
6. 黄长琴, 钟艳. 脑卒中患者运动功能障碍康复治疗新进展. 检验医学与临床, 2017, 14(3): 449-451.
7. Maraka S, Jiang Q, Jafari-Khouzani K, et al. Degree of corticospinal tract damage correlates with motor function after stroke. Ann Clin Transl Neurol, 2014, 1(11): 891-899.
8. 陈自谦, 张碧云, 倪萍, 等. 功能磁共振成像对脑缺血运动功能重组和康复的临床研究. 福州总医院学报, 2008, 15(3): 202-205, 246.
9. 宋婧源, 元小冬, 吕淑娟, 等. 体感诱发电位在脑卒中患者中应用价值的研究进展. 实用心脑肺血管病杂志, 2017, 25(12): 1-4.
10. 刘建民, 郑健. 诱发电位在脑卒中患者脑功能评估中的应用. 中国临床康复, 2004, 8(7): 1316-1318.
11. Edwards MJ, Talelli P, Rothwell JC. Clinical applications of transcranial magnetic stimulation in patients with movement disorders. Lancet Neurol, 2008, 7(9): 827-840.
12. Simonetta-Moreau M. Non-invasive brain stimulation (NIBS) and motor recovery after stroke. Ann Phys Rehabil Med, 2014, 57(8): 530-542.
13. Rehme AK, Fink GR, von Cramon DY, et al. The role of the contralesional motor cortex for motor recovery in the early days after stroke assessed with longitudinal FMRI. Cereb Cortex, 2011, 21(4): 756-768.
14. Hosomi K, Morris S, Sakamoto T, et al. Daily repetitive transcranial magnetic stimulation for poststroke upper limb paresis in the subacute period. J Stroke Cerebrovasc Dis, 2016, 25(7): 1655-1664.
15. 陆如蓝, 张成亮, 周先举. 重复经颅磁刺激在脑卒中康复中的临床应用进展. 医学综述, 2018, 24(6): 1097-1102.
16. Smith MC, Stinear CM. Transcranial magnetic stimulation (TMS) in stroke: ready for clinical practice?. J Clin Neurosci, 2016, 31(9): 10-14.
17. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol, 2000, 527(Pt 3): 633-639.
18. Hummel F, Cohen LG. Improvement of motor function with noninvasive cortical stimulation in a patient with chronic stroke. Neurorehabil Neural Repair, 2005, 19(1): 14-19.
19. Nair DN, Renga V, Hamelin S, et al. Improving motor function in chronic stroke patients using simultaneous occupational therapy and tDCS. Stroke, 2008, 39(2): 542.
20. Fregni F, Boggio PS, Mansur CG, et al. Transcranial direct current stimulation of the unaffected hemisphere in stroke patients. Neuroreport, 2005, 16(14): 1551-1555.
21. 励建安. 康复治疗技术新进展. 北京: 人民军医出版社, 2015.
22. 郑彭, 黄国志. 下肢康复机器人在脑卒中患者运动功能障碍中的应用进展. 中国康复医学杂志, 2017, 32(6): 716-719.
23. Laver KE, George S, Thomas S, et al. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev, 2015, 43(2): CD008349.
24. Darekar A, Mcfadyen BJ, Lamontagne A, et al. Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review. J Neuroeng Rehabil, 2015, 12(1): 46.
25. 瞿畅, 艾波, 郭爱松, 等. 基于 Kinect 的上肢康复训练系统开发与应用. 中国生物医学工程学报, 2015, 34(5): 607-612.
26. 汪洁, 吴东宇, 宋为群, 等. 双额叶在线经颅直流电刺激对失语症图命名的作用. 中国康复医学杂志, 2014, 29(1): 31-35.
27. 汪洁, 吴东宇, 袁英, 等. 应用在线经颅直流电刺激探查外侧裂后部对失语症恢复的作用. 中国康复医学杂志, 2011, 26(5): 106-410.
28. 张雅妮, 刘爱玲, 练涛. 经颅直流电刺激在脑卒中后失语症康复中的应用. 中西医结合心脑血管病杂志, 2018, 16(3): 308-310.
29. 王俊霞, 年莉. 中风后失语的中医治疗研究进展. 中医临床研究, 2012, 4(1): 114-116.
30. 中国吞咽障碍康复评估与治疗专家共识组. 中国吞咽障碍评估与治疗专家共识(2017 年版). 中华物理医学与康复杂志, 2018, 40(1): 1-10.
31. Demir N, Serel Arslan S, Inal Ö, et al. Reliability and validity of the Turkish eating assessment tool (T-EAT-10). Dysphagia, 2016, 31(5): 644-649.
32. 李丽. 脑卒中的康复治疗及进展. 上海: 复旦大学, 2014.
33. Lee JH, Kim SB, Lee KW, et al. Effect of repetitive transcranial magnetic stimulation according to the stimulation site in stroke patients with dysphagia. Ann Rehabil Med, 2015, 39(3): 432-439.
34. Khedr EM, Abo-Elfetoh N, Rothwell JC. Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation. Acta Neurol Scand, 2009, 119(3): 155-161.
35. Kim L, Chun MH, Kim BR, et al. Effect of repetitive transcranial magnetic stimulation on patients with brain injury and dysphagia. Ann Rehabil Med, 2011, 35(6): 765-771.
36. Park JW, Oh JC, Lee JW, et al. The effect of 5 Hz high-frequency rTMS over contralesional pharyngeal motor cortex in post-stroke oropharyngeal dysphagia: a randomized controlled study. Neurogastroenterol Motil, 2013, 25(4): 324-e250.
37. Park E, Kim MS, Chang WH, et al. Effects of bilateral repetitive transcranial magnetic stimulation on post-stroke dysphagia. Brain Stimul, 2017, 10(1): 75-82.
38. Michou E, Raginis-Zborowska A, Watanabe M, et al. Repetitive transcranial magnetic stimulation: a novel approach for treating oropharyngeal dysphagia. Curr Gastroenterol Rep, 2016, 18(2): 10.
39. 窦祖林. 吞咽障碍评估与治疗. 2版. 北京: 人民卫生出版社, 2017.
40. Gu SY, Chang MC. The effects of 10-Hz repetitive transcranial magnetic stimulation on depression in chronic stroke patients. Brain Stimul, 2017, 10(2): 270-274.
41. Kedzior KK, Reitz SK. Short-term efficacy of repetitive transcranial magnetic stimulation (rTMS) in depression- reanalysis of data from meta-analyses up to 2010. BMC Psychology, 2014, 2(1): 39.
42. Mcintyre A, Thompson S, Burhan A, et al. Repetitive transcranial magnetic stimulation for depression due to cerebrovascular disease: a systematic review. J Stroke Cerebrovasc Dis, 2016, 25(12): 2792-2800.
43. Zheng MX, Hua XY, Feng JT, et al. Trial of contralateral seventh cervical nerve transfer for spastic arm paralysis. N Engl J Med, 2018, 378(1): 22-34.
44. Madanat JP, Geraci S, Jajoo P, et al. Musculoskeletal pain as a novel complication after posterior tibial nerve block in stroke and traumatic brain injury patients. PM R, 2011, 3(5): 492-494.

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