Grenthe Olsson Barbro, Sunnerhagen Katharina Stibrant
Institute of Clinical Neuroscience-Rehabilitation Medicine, Sahlgrenska Academy, Göteborg University, Rehabilitation Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
J Stroke Cerebrovasc Dis. 2007 Sep-Oct;16(5):208-15. doi: 10.1016/j.jstrokecerebrovasdis.2007.06.002.
This study prospectively evaluated long-term outcome 2 years after 6-8 weeks of day hospital rehabilitation (DHR) for stroke in younger patients. Assessment findings after discharge from DHR and at follow-up 2 years later using 3 instruments--the FIM (originally known as the Functional Independence Measure), SF-36, and EuroQol (now known as EQ-5D)--were compared. The study group comprised 50 consecutive patients age 18-60 years at the time of their initial stroke who had participated in a prospective study of the effects of DHR after stroke. Living conditions were assessed using the Riks-Stroke stroke care register. Patient handicaps were graded according to the Oxford Handicap Scale. The patients maintained functional and cognitive capacity, as well as self-rated health and health-related quality of life (HRQoL), 2 years after discharge. A significant improvement was also seen in cognitive capacity and in HRQoL as assessed by EuroQol, but in only 1 of the 8 SF-36 domains. The changes in functional capacity and HRQoL were significantly and inversely correlated with the scores at discharge from DHR. Follow-up scores for EuroQol were correlated with scores for physical and cognitive capacity. Women demonstrated less improvement in EuroQol scores than men. Our findings indicate that most stroke patients who sustained initial acute stroke at age 18-60 years and received 6-8 weeks of DHR poststroke maintained functional and cognitive capacity as well as HRQoL after 2 years. Some patients even may have improved their cognitive capacity and HRQoL.
本研究对年轻中风患者进行为期6 - 8周的日间医院康复（DHR）治疗2年后的长期预后进行了前瞻性评估。比较了DHR出院后以及2年后随访时使用三种工具（FIM，原称为功能独立性测量；SF - 36；EuroQol，现称为EQ - 5D）的评估结果。研究组包括50例首次中风时年龄在18 - 60岁之间的连续患者，这些患者参与了一项关于中风后DHR效果的前瞻性研究。使用瑞典中风护理登记册评估生活状况。根据牛津残疾量表对患者残疾程度进行分级。患者在出院2年后保持了功能和认知能力，以及自我评估的健康状况和与健康相关的生活质量（HRQoL）。通过EuroQol评估，认知能力和HRQoL也有显著改善，但仅在SF - 36的8个领域中的1个领域。功能能力和HRQoL的变化与DHR出院时的评分显著且呈负相关。EuroQol的随访评分与身体和认知能力评分相关。女性在EuroQol评分上的改善不如男性。我们的研究结果表明，大多数在18 - 60岁首次发生急性中风并在中风后接受6 - 8周DHR治疗的患者在2年后保持了功能和认知能力以及HRQoL。一些患者甚至可能改善了他们的认知能力和HRQoL。
