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基于社区的康复以改善中风幸存者的康复参与度和功能恢复。

Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.

作者信息

Ru Xiaojuan, Dai Hong, Jiang Bin, Li Ninghua, Zhao Xingquan, Hong Zhen, He Li, Wang Wenzhi

机构信息

From the Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University (XR, BJ, WW); Beijing Municipal Key Laboratory of Clinical Epidemiology (XR, BJ, WW); Department of Rehabilitation Medicine, School of Public Health and Family Medicine, Capital Medical University (HD); Department of Epidemiology, Beijing Hospital (NL); Department of Neurology, Beijing Tiantan Hospital (XZ), Beijing; Department of Neurology, Shanghai Huashan Hospital, Fudan University, Shanghai (ZH); and Department of Neurology, West China Hospital, Sichuan University, Chengdu (LH), China.

出版信息

Am J Phys Med Rehabil. 2017 Jul;96(7):e123-e129. doi: 10.1097/PHM.0000000000000650.

Abstract

OBJECTIVE

The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors.

DESIGN

This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community. Two sampling surveys, at baseline and after intervention, were administered to evaluate the rehabilitation activity undertaken. In intervention communities, stroke survivor's motor function, daily activity, and social activity were evaluated pretreatment and posttreatment, using the Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire.

RESULTS

The proportion of individuals participating in rehabilitation-related activity was increased significantly (P < 0.05) in intervention communities, as compared with control communities. In intervention communities, the patients' Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire scores were significantly improved after rehabilitation (P < 0.05) across all ages and disease courses, except for the FAQ scores in patients younger than 50 years (P > 0.05).

CONCLUSIONS

Community-based rehabilitation appropriate technique increases rehabilitation participation rates and enhances motor function, daily activity, and social activity of stroke survivors.

摘要

目的

本研究旨在评估基于社区的康复适宜技术(CRAT)干预项目在提高中风幸存者康复参与度和改善功能恢复方面的有效性。

设计

本研究采用准实验设计。在为约50000人服务的5个中心中,每个中心指定2个社区分别作为干预社区或对照社区。在干预社区定期实施包括2年康复教育和3个月CRAT治疗的CRAT干预项目,而对照社区不进行特殊干预。在基线和干预后进行两次抽样调查,以评估所开展的康复活动。在干预社区,使用Fugl-Meyer运动功能评估、Barthel指数和社会功能活动问卷,在治疗前和治疗后对中风幸存者的运动功能、日常活动和社会活动进行评估。

结果

与对照社区相比,干预社区参与康复相关活动的个体比例显著增加(P < 0.05)。在干预社区,除50岁以下患者的FAQ评分外(P > 0.05),所有年龄和病程的患者在康复后Fugl-Meyer运动功能评估、Barthel指数和社会功能活动问卷评分均显著改善(P < 0.05)。

结论

基于社区的康复适宜技术可提高中风幸存者的康复参与率,并增强其运动功能、日常活动和社会活动能力。

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