The changes of serum inflammatory cytokines in patients with hemiplegia after ischemic stroke and the rehabilitation effects.

Abstract

Background: Acute ischemic stroke (AIS) often leads to hemiplegia, significantly impairing neurological function, motor ability, and daily life activities. Early precision exercise rehabilitation has emerged as a promising intervention to enhance recovery. This study evaluated its effectiveness in improving neurological function, gait performance, and self-care ability and reducing inflammatory response in hemiplegic patients.

Methods: This retrospective cohort study included 230 patients with hemiplegia due to AIS, admitted within 72 hours of onset. Patients were divided into an Early Rehabilitation Group (EG, n = 132) and a Conventional Rehabilitation Group (CG, n = 98) based on the intervention received. The EG underwent early precision exercise rehabilitation, integrating neurofunctional training, motor-evoked potential (MEP) therapy, and functional electrical stimulation (FES), while the CG received traditional rehabilitation. The effectiveness was assessed using the National Institutes of Health Stroke Scale (NIHSS), Wisconsin Gait Scale (WGS), and Activities of Daily Living (ADL) scores. Serum inflammatory markers (TNF-a, hs-CRP IL-6, IL-18) were also measured before and after treatment.

Results: The EG demonstrated significantly more significant improvements in NIHSS (5.85± 1.31 vs 7.03± 2.54, P< 0.05), WGS (24.81± 3.06 vs. 31 .96 ± 4.62 , P< 0.05), and ADL scores (63.08± 4.93 vs. 51 .78 ± 6.34 , P< 0.05) compared to the CG. Walking frequency and speed were also higher in the EG (P< 0.05). Inflammatory markers significantly decreased post-treatment in the EG (TNF-a: P< 0.05, hs-CRP: P< 0.05, IL-6: P< 0.05, IL-18: P< 0.05), suggesting a reduction in systemic inflammation.

Conclusions: Early precision exercise rehabilitation significantly enhances neurological function, motor ability, and self-care capacity, reducing inflammatory response in hemiplegic AIS patients. These findings support its integration into clinical stroke rehabilitation protocols.