College of Physiotherapy, Wroclaw, Poland.
Med Sci Monit. 2011 Sep;17(9):CR510-6. doi: 10.12659/msm.881938.
The objective of our study was to evaluate a goal-driven strategic plan for the step-by-step rehabilitation of traumatic brain injury (TBI) patients, with effectiveness measured in terms of quality of life, as compared to patients treated according to a standard, progressive rehabilitation program.
MATERIAL/METHODS: We studied 40 patients after TBI awakened from a long-term coma. The patients were divided into two equal groups: a control group (n=20) involving patients treated before the introduction of the strategic approach, and an experimental group (n=20) involving patients rehabilitated under the strategic approach. In evaluating the effectiveness of rehabilitation we used a structured interview with clinical observation and a scale for assessing the quality of life of patients after TBI.
The deterioration in the quality of life of TBI patients is mainly related to difficulties in satisfying physiological needs, self-care, reduced mobility and disorders of cognitive, regulatory, and social functions. In both groups, the feature most susceptible to rehabilitation related change was movement, while the least susceptible functions were associated with the use of different means of transport. This change is significantly greater in persons in the experimental group, as compared to controls.
We found that a rehabilitation program controlled by a strategic plan, with the cooperation of the patient, is more effective in improving the quality of life, as the patient is more self-motivated to individually designed objectives.
我们研究的目的是评估创伤性脑损伤（TBI）患者分阶段康复的目标驱动战略计划的有效性，其有效性通过生活质量来衡量，与根据标准的渐进式康复计划治疗的患者相比。
材料/方法：我们研究了 40 名从长期昏迷中苏醒的 TBI 患者。患者分为两组，每组 20 人：对照组（n=20）包括采用战略方法前治疗的患者，实验组（n=20）包括采用战略方法康复的患者。在评估康复效果时，我们使用了结构化访谈、临床观察和 TBI 患者生活质量评估量表。
TBI 患者生活质量的恶化主要与满足生理需求、自我护理、活动能力下降以及认知、调节和社会功能障碍有关。在两组患者中，最容易受到康复相关变化影响的特征是运动，而最不容易受影响的功能与使用不同的交通工具有关。实验组患者的变化明显大于对照组。
我们发现，由患者合作控制的康复计划更有效，可以提高生活质量，因为患者更有动力为个人设计的目标而努力。
