Lequerica Anthony H, Rapport Lisa J, Loeher Kristen, Axelrod Bradley N, Vangel Stephen J, Hanks Robin A
Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, MI, USA.
J Head Trauma Rehabil. 2007 May-Jun;22(3):177-83. doi: 10.1097/01.HTR.0000271118.96780.bc.
To examine the nature of agitation in patients with brain injury and quantify the relation between agitation and patient progress in rehabilitation.
Cross-sectional, correlational.
Urban, inpatient rehabilitation facility in the midwestern United States.
Sixty-nine patients with acquired brain injury admitted to an acute rehabilitation hospital.
Therapy Engagement using the Rehabilitation Therapy Engagement Scale; Functional Status using the Functional Independence Measure.
Agitated behavior was inversely associated with engagement in rehabilitation therapy even after controlling for injury severity. Engagement in therapy mediated the relation between agitated behavior and progress in rehabilitation as assessed using a Functional Independence Measure efficiency ratio.
Progress in acute brain injury rehabilitation appears to be meaningfully influenced by the complex interplay among injury severity, agitation, and engagement. The findings are consistent with a theoretical model, suggesting that agitated patients make less progress in rehabilitation not only because of greater injury severity but also because agitation disrupts engagement in rehabilitation therapies. Multiple clinical purposes may be better served by measuring behavioral excess on a continuum than in a dichotomous fashion.
研究脑损伤患者躁动的本质，并量化躁动与患者康复进展之间的关系。
横断面相关性研究。
美国中西部的城市住院康复机构。
69名入住急性康复医院的后天性脑损伤患者。
使用康复治疗参与量表评估治疗参与度；使用功能独立性测量评估功能状态。
即使在控制损伤严重程度后，躁动行为仍与康复治疗参与度呈负相关。治疗参与介导了躁动行为与使用功能独立性测量效率比评估的康复进展之间的关系。
急性脑损伤康复进展似乎受到损伤严重程度、躁动和参与度之间复杂相互作用的显著影响。这些发现与一个理论模型一致，表明躁动患者康复进展较慢不仅是因为损伤严重程度更高，还因为躁动扰乱了康复治疗的参与度。通过在连续体上测量行为过度而非二分法，可能更好地满足多种临床目的。
