Kalichman Leonid, Alperovitch-Najenson Deborah, Treger Iuly
a Department of Physical Therapy , Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel ;
b Department of Environmental and Occupational Health , Sackler Faculty of Medicine, Tel Aviv University , Israel ;
Disabil Rehabil. 2016 Aug;38(17):1684-90. doi: 10.3109/09638288.2015.1107640. Epub 2016 Jan 10.
Purpose To evaluate the influence of patient's weight on rehabilitation outcomes in first-event stroke patients. Design Retrospective, observational comparative study. 102 first-time stroke male and female patients admitted to the 52-bed neurology rehabilitation department in a rehabilitation hospital were included in the study. Body mass index (BMI), Functional Independence Measure (FIM) on admission and at discharge, as well as the delta-FIM (FIM on admission - FIM at discharge) were evaluated. The Kruskal-Wallis test was used to compare the FIM and the NIHSS scores between BMI groups (normal, overweight, moderate and severe obesity). Results A statistically significant negative correlation (rho = -0.20, p = 0.049) was found between FIM change and BMI, that remained significant after adjustments for age, sex and hospitalisation days. No difference was found between groups in FIM or NIHSS change between BMI groups. Conclusions In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. Further investigations are needed to identify the functional parameters affected by the patients' BMI. Implications for Rehabilitation In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. New rehabilitation strategies should be designed to improve the functional outcomes of rehabilitation of obese patients.
目的 评估患者体重对首次发生卒中患者康复结局的影响。设计 回顾性观察性比较研究。本研究纳入了一家康复医院52张床位的神经康复科收治的102例首次发生卒中的男性和女性患者。评估了体重指数(BMI)、入院时和出院时的功能独立性测量(FIM)以及FIM差值(入院时FIM - 出院时FIM)。采用Kruskal-Wallis检验比较BMI组(正常、超重、中度和重度肥胖)之间的FIM和美国国立卫生研究院卒中量表(NIHSS)评分。结果 发现FIM变化与BMI之间存在统计学显著的负相关(rho = -0.20,p = 0.049),在对年龄、性别和住院天数进行调整后仍具有显著性。BMI组之间在FIM或NIHSS变化方面未发现差异。结论 在康复医院接受康复治疗的亚急性卒中后患者中,BMI与功能参数的改善呈负相关。在预测卒中患者的康复结局时应考虑患者的BMI。需要进一步研究以确定受患者BMI影响的功能参数。对康复的启示 在康复医院接受康复治疗的亚急性卒中后患者中,BMI与功能参数的改善呈负相关。在预测卒中患者的康复结局时应考虑患者的BMI。应设计新的康复策略以改善肥胖患者的康复功能结局。