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照顾者介导的运动疗法在脑卒中后康复中的疗效与安全性

Efficacy and Safety of Caregiver-Mediated Exercise in Post-stroke Rehabilitation.

作者信息

Lee Min Jun, Yoon Seihee, Kang Jung Joong, Kim Jungin, Kim Jong Moon, Han Jun Young

机构信息

Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea.

出版信息

Ann Rehabil Med. 2018 Jun 27;42(3):406-415. doi: 10.5535/arm.2018.42.3.406.

Abstract

OBJECTIVE

To assess the efficacy and safety of our 4-week caregiver-mediated exercise (CME) in improving trunk control capacity, gait, and balance and in decreasing concerns about post-stroke falls when there is an increase in its efficacy.

METHODS

Acute or subacute stroke survivors were assigned to either the trial group (n=35) or the control group (n=37). Changes in Modified Barthel Index (MBI), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), and Trunk Impairment Scale (TIS) scores at 4 weeks from baseline served as primary outcome measures. Correlations of primary outcome measures with changes in Fall Efficacy Scale-International (FES-I) scores at 4 weeks from baseline in the trial group served as secondary outcome measures. Treatment-emergent adverse events (TEAEs) served as safety outcome measures.

RESULTS

There were significant differences in changes in MBI, FAC, BBS, TIS-T, TIS-D, TIS-C, and FES-I scores at 4 weeks from baseline between the two groups (all p<0.0001). There were no significant (p=0.0755) differences in changes in TIS-S scores at 4 weeks from baseline between the two groups. MBI, FAC, BBS, and TIS scores showed significantly inverse correlations with FES-I scores in patients receiving CME. There were no TEAEs in our series.

CONCLUSION

CME was effective and safe in improving the degree of independence, ambulation status, dynamic and static balance, trunk function, and concerns about post-stroke falls in stroke survivors.

摘要

目的

评估为期4周的照护者介导运动(CME)在提高躯干控制能力、步态和平衡能力以及在提高疗效时减少对中风后跌倒的担忧方面的疗效和安全性。

方法

将急性或亚急性中风幸存者分为试验组(n = 35)和对照组(n = 37)。以基线后4周时改良Barthel指数(MBI)、功能性步行分类(FAC)、Berg平衡量表(BBS)和躯干损伤量表(TIS)评分的变化作为主要结局指标。试验组中基线后4周时主要结局指标与跌倒效能量表-国际版(FES-I)评分变化的相关性作为次要结局指标。治疗中出现的不良事件(TEAE)作为安全性结局指标。

结果

两组在基线后4周时MBI、FAC、BBS、TIS-T、TIS-D、TIS-C和FES-I评分的变化存在显著差异(均p<0.0001)。两组在基线后4周时TIS-S评分的变化无显著差异(p = 0.0755)。接受CME的患者中,MBI、FAC、BBS和TIS评分与FES-I评分呈显著负相关。本研究系列中未出现TEAE。

结论

CME在改善中风幸存者的独立程度、步行状态、动态和静态平衡、躯干功能以及对中风后跌倒的担忧方面是有效且安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f18f/6058591/89892822f31f/arm-2018-42-3-406f1.jpg

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