León-Carrión José, Machuca-Murga Fernando, Solís-Marcos Ignacio, León-Domínguez Umberto, Domínguez-Morales María Del Rosario
Human Neuropsychology Laboratory, School of Psychology, Department of Experimental Psychology, University of Seville, Seville, Spain.
Brain Inj. 2013;27(10):1119-23. doi: 10.3109/02699052.2013.804204. Epub 2013 Jul 29.
To determine whether early neurorehabilitation improves a patient's functional recovery.
A retrospective study was carried out on patients with severe traumatic brain injury (TBI) who underwent a minimum of 4 months of integral and multidisciplinary neurorehabilitation.
Fifty-eight patients with severe TBI were assessed at admission and at discharge using the FIM + FAM scale. Two groups were formed based on time elapsed from brain injury to onset of rehabilitation. The early treatment group (ET) included patients who began rehabilitation within the first 9 months post-trauma; the late treatment group (LT) began after the 9-month cut-off date. Intra- and between-group analysis of FIM + FAM scores were carried out at admission and discharge. Multiple linear regression was used to determine the best predictors for functional rehabilitation.
After neurorehabilitation, all subjects showed significant improvement in cognitive, motor, communication and psychosocial functioning. Moreover, the ET group showed better global functional outcome at discharge than patients who began later treatment. The best predictors for functional neurorehabilitation were months since injury, age, GCS score and months of treatment.
It is concluded that the sooner patients begin neurorehabilitation, the better their functional outcome.
确定早期神经康复是否能改善患者的功能恢复情况。
对至少接受了4个月综合多学科神经康复治疗的重度创伤性脑损伤（TBI）患者进行了一项回顾性研究。
使用FIM + FAM量表对58例重度TBI患者在入院时和出院时进行评估。根据从脑损伤到康复开始的时间将患者分为两组。早期治疗组（ET）包括创伤后前9个月内开始康复的患者；晚期治疗组（LT）在9个月截止日期之后开始康复。在入院时和出院时对FIM + FAM评分进行组内和组间分析。使用多元线性回归来确定功能康复的最佳预测指标。
神经康复治疗后，所有受试者在认知、运动、沟通和心理社会功能方面均有显著改善。此外，ET组出院时的整体功能结局优于开始较晚治疗的患者。功能神经康复的最佳预测指标是受伤后的月数、年龄、格拉斯哥昏迷量表（GCS）评分和治疗月数。
得出的结论是，患者开始神经康复治疗越早，其功能结局越好。
