Hokstad Anne, Indredavik Bent, Bernhardt Julie, Langhammer Birgitta, Gunnes Mari, Lundemo Christine, Bovim Martina Reiten, Askim Torunn
Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
J Rehabil Med. 2016 Mar;48(3):280-6. doi: 10.2340/16501977-2051.
To assess the amount of early upright activity of patients managed in Norwegian stroke units and its association with functional outcome and health-related quality of life 3 months later.
A prospective observational multi-centre study.
A total of 390 acute stroke patients, mean age 76.8 years, 48.1% men, less than 14 days post-stroke, recruited from 11 Norwegian stroke units.
Time spent in different activity categories (in bed, sitting out of bed, upright) was observed with a standard method. Outcome was assessed by modified Rankin Scale (mRS), and health-related quality of life by EuroQol-5 Dimension 5 level (EQ-5D-5L) 3 months later. Ordinal logistic and linear regression analyses were used to examine the association between activity categories and mRS and EQ-5D-5L, respectively. Age, National Institute of Health Stroke Scale (NIHSS) score, premorbid mRS, sex, and hospital-site were added as covariates.
The odds ratio (OR) (95% confidence interval (CI)) for poorer functional outcome (higher mRS) decreased as time spent in upright activities increased (OR 0.97 (95% CI 0.94-1.00)). There was also a significant positive association between time in upright activity and higher EQ-5D-5L, Beta 0.184 (95% CI 0.001- 0.008) 3 months later.
This study confirms the beneficial effect of upright activity applied during hospital stay in Norwegian stroke units.
评估挪威卒中单元中患者的早期直立活动量及其与3个月后功能结局和健康相关生活质量的关联。
一项前瞻性观察性多中心研究。
从11个挪威卒中单元招募的390例急性卒中患者，平均年龄76.8岁，男性占48.1%，卒中后不到14天。
采用标准方法观察患者在不同活动类别（卧床、坐在床边、直立）所花费的时间。3个月后，通过改良Rankin量表（mRS）评估结局，通过欧洲五维健康量表5级（EQ-5D-5L）评估健康相关生活质量。分别采用有序逻辑回归和线性回归分析来检验活动类别与mRS和EQ-5D-5L之间的关联。将年龄、美国国立卫生研究院卒中量表（NIHSS）评分、病前mRS、性别和医院地点作为协变量纳入分析。
随着直立活动时间的增加，功能结局较差（mRS较高）的比值比（OR）（95%置信区间（CI））降低（OR 0.97（95%CI 0.94 - 1.00））。3个月后，直立活动时间与较高的EQ-5D-5L之间也存在显著的正相关，β值为0.184（95%CI 0.001 - 0.008）。
本研究证实了挪威卒中单元住院期间进行直立活动的有益效果。
