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急性脑卒中患者早期强化康复治疗的效果:日本医院回顾性前后对照研究。

Effect of early and intensive rehabilitation in acute stroke patients: retrospective pre-/post-comparison in Japanese hospital.

机构信息

a Department of Rehabilitation , Araki Neurosurgical Hospital , Japan , Hiroshima.

b Department of Neurosurgery , Araki Neurosurgical Hospital , Hiroshima , Japan.

出版信息

Disabil Rehabil. 2018 Jun;40(12):1452-1455. doi: 10.1080/09638288.2017.1300337. Epub 2017 Mar 14.

DOI:10.1080/09638288.2017.1300337
PMID:28291953
Abstract

PURPOSE

There is little high-quality or large-scale clinical research focusing on the effect of early and intensive rehabilitation in Eastern countries. This study aimed to determine whether an early and intensive rehabilitation program in a Japanese hospital affects functional outcomes of acute stroke patients.

METHODS

In total, 1588 stroke patients were investigated. A maintained database of all hospitalized acute stroke patients admitted to our facility over two consecutive 2-year periods was reviewed. We relaunched of a new rehabilitation program to be earlier and more intensive at the midpoint of this two periods. The functional outcomes of the patients in the first 2-year period and the subsequent 2-year period were compared.

RESULTS

The total time of rehabilitation exercises per day was significantly increased from the first period to the second period. The number of patients who started rehabilitation within 24 h after admission was significantly increased in the patients admitted during the second period compared with those admitted during the first period. The Functional Independence Measure (FIM) efficiency was significantly higher in the patients admitted during the second period than in those admitted during the first period.

CONCLUSIONS

An early and intensive rehabilitation program in a Japanese hospital affects functional outcomes of acute stroke patients. Implications for Rehabilitation Early and intensive rehabilitation for the stroke patients is an effective means of improving FIM score. Early and intensive rehabilitation affects the improvement of FIM efficiency without increasing adverse events.

摘要

目的

在东方国家,针对早期强化康复的效果,鲜有高质量或大规模的临床研究。本研究旨在确定日本医院内早期强化康复方案是否会影响急性脑卒中患者的功能结局。

方法

共纳入 1588 例脑卒中患者。对我院连续两个 2 年期间所有住院急性脑卒中患者的数据库进行了回顾性分析。在这两个时间段的中间,我们重新启动了一个新的更早、更强化的康复方案。比较了前 2 年和后 2 年期间患者的功能结局。

结果

每天的康复锻炼总时间从第一阶段显著增加到第二阶段。与第一阶段相比,第二阶段入院患者中开始康复治疗的时间在发病后 24 小时内的患者数量显著增加。第二阶段入院患者的功能独立性测量(FIM)效率明显高于第一阶段入院患者。

结论

日本医院内的早期强化康复方案会影响急性脑卒中患者的功能结局。

意义

对脑卒中患者进行早期强化康复是提高 FIM 评分的有效手段。早期强化康复可改善 FIM 效率,而不会增加不良事件。

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