Bender Andreas, Bauch Stefan, Grill Eva
Therapiezentrum Burgau , Burgau , Germany .
Brain Inj. 2014;28(1):44-50. doi: 10.3109/02699052.2013.850177.
Patients with severe acute brain injury often suffer from prolonged limitations in the activities of daily living (ADL) after completion of initial neurorehabilitation.
To analyse the efficacy of an inpatient interval rehabilitation programme (IRP) focused on patient goals in the chronic disease state.
Retrospective longitudinal cohort study of IRP patients. Clinical scoring of ADLs was performed weekly during inpatient treatment. IRP success was rated with the Goal Attainment Scale. Regression analysis was used to identify factors that influence IRP success.
Data from 125 patients (50.4 years) were analysed. Delay between discharge from acute/sub-acute rehabilitation and admission to IRP was 552 days. IRP lasted for 46 days and 37% of rehabilitation attempts were rated as successful. A significant increase in FIM scores from 33 ± 22 to 36 ± 24 points (p < 0.001) occurred. Higher ADL scores at discharge from acute/sub-acute rehabilitation and decannulation of a tracheostomy tube as the primary IRP goal made an IRP success more likely.
Even several years after severe acute brain injury, an ICF-oriented IRP can lead to ADL improvements and achievement of specific goals. If confirmed by prospective trials, this strategy should be incorporated in healthcare systems.
重症急性脑损伤患者在初始神经康复完成后，日常生活活动（ADL）往往会长期受限。
分析以患者目标为导向的住院间歇康复计划（IRP）在慢性病状态下的疗效。
对IRP患者进行回顾性纵向队列研究。住院治疗期间每周对ADL进行临床评分。使用目标达成量表对IRP的成功进行评估。采用回归分析确定影响IRP成功的因素。
分析了125例患者（50.4岁）的数据。急性/亚急性康复出院与IRP入院之间的间隔为552天。IRP持续46天，37%的康复尝试被评为成功。FIM评分从33±22分显著提高到36±24分（p<0.001）。急性/亚急性康复出院时较高的ADL评分以及将气管切开管拔管作为IRP的主要目标，使IRP成功的可能性更大。
即使在重症急性脑损伤数年之后，以国际功能、残疾和健康分类（ICF）为导向的IRP也可改善ADL并实现特定目标。如果前瞻性试验证实，该策略应纳入医疗保健系统。
