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[The recovery process of motor function in elderly patients with cerebrovascular disease].

AIM
To investigate the recovery process in elderly patients with cerebrovascular disease for 10 months, from beginning 3 months after the onset of disease. This was done according to the evaluation of exercise capacity described in the interim-report on preventive long-term care services in city, town and village model research.


METHODS
Fourteen patients in whom cerebrovascular disease had been diagnosed within the previous 3 months, and who were still receiving rehabilitation treatment (8 men, 6 women, average age 76.4+/-8.3, and average number of hospitalization days 164.6+/-33.1) were enrolled. Evaluation items were: the grip power, one-leg standing time with eyes open, functional reach, timed up and go test (TUGT) and falling bar test. The maximum recovery value of individual measurements in each patient was considered 100%, in order to calculate the recovery rate.


RESULTS
The maximum recovery value of the grip power test was obtained on both unaffected and affected body sides 6 months after the onset of disease, but the recovery values of both the unaffected and affected sides decreased to 76.1% and 68.6% respectively, after 12 months. The maximum recovery value of the one-leg standing time with eyes open test was 72.8% 7 months after the onset of disease, but it had decreased to 24.5% after 12 months. The maximum recovery value of the functional reach test was 86.9% 4 months after the onset of disease, but it had decreased to 57.5% after 12 months. The maximum recovery value of the falling bar test was 83.5% 6 months after the onset of disease, but had it decreased to 63.8% after 12 months. The maximum recovery value of the TUGT was 90.4% 5 months after the onset of disease, but it had decreased to 64.1% after 12 months.


CONCLUSIONS
The TUGT reached the recovery peak level first, however, the one-leg standing test reached the maximum recovery value 7 months after the onset of disease, slightly later than the other measurements. After achieving the maximum recovery value, the grip power test maintained its value in comparison with the other tests, but the one-leg standing, functional reach, falling bar test and TUGT continued to decrease. In particular, the one-leg standing and functional reach tests, which relate to equilibrium function, showed a remarkable decrease in recovery values. Fall-prevention measures are urgently needed because the reduction of equilibrium function level increases the risk of falling, and producing a second any injury after cerebrovascular disease. This suggests that how rehabilitation treatment is performed should be examined after discharge from hospital.