Demir Yasin, Köroğlu Özlem, Tekin Elif, Adıgüzel Emre, Kesikburun Serdar, Güzelküçük Ümüt, Yılmaz Bilge, Alaca Rıdvan, Yaşar Evren
Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara, Turkey.
Turk J Phys Med Rehabil. 2018 Dec 9;65(1):67-73. doi: 10.5606/tftrd.2019.2281. eCollection 2019 Mar.
This study aims to investigate the effect of rehabilitation on functional level of traumatic brain injury (TBI) patients and to examine the associated factors on functional gain in this patient population.
Between October 2010 and November 2015, a total of 71 patients (63 males, 8 females; mean age 26.6±8.1 years; range, 18 to 56 years) who were admitted to our rehabilitation clinic with moderate-to-severe TBI were retrospectively analyzed. Functional recovery was assessed using the Functional Independence Measure (FIM) and Functional Ambulation Classification (FAC) scales. The patients were divided into two groups according to time from TBI to the initiation of rehabilitation: early (<6 months) and late (≥6 months). Possible predictive factors associated with FIM gain were evaluated.
There was a significant improvement in the FIM scores from admission to discharge (p<0.001). There was a statistically significant difference in the FIM gain and FIM efficiency between the patient groups according to the initiation of rehabilitation (p<0.001). The FAC scores increased from admission to discharge, showing statistical significance (p<0.001). Duration of rehabilitation, early rehabilitation, heterotopic ossification, and deep venous thrombosis were found to be significant factors associated with FIM gain (p<0.001).
Our study results suggest that rehabilitation is effective for functional gain, particularly in the early period in patients with moderate- to-severe TBI and duration of rehabilitation, early rehabilitation, heterotopic ossification, and deep venous thrombosis are also predictors of functional improvement.
本研究旨在探讨康复治疗对创伤性脑损伤（TBI）患者功能水平的影响，并研究该患者群体功能改善的相关因素。
回顾性分析2010年10月至2015年11月期间，共71例（63例男性，8例女性；平均年龄26.6±8.1岁；范围18至56岁）因中重度TBI入住我院康复科的患者。使用功能独立性测量（FIM）和功能步行分类（FAC）量表评估功能恢复情况。根据从TBI到开始康复的时间将患者分为两组：早期（<6个月）和晚期（≥6个月）。评估与FIM改善相关的可能预测因素。
从入院到出院，FIM评分有显著改善（p<0.001）。根据康复开始时间，患者组之间的FIM改善和FIM效率存在统计学显著差异（p<0.001）。FAC评分从入院到出院增加，具有统计学意义（p<0.001）。发现康复持续时间、早期康复、异位骨化和深静脉血栓形成是与FIM改善相关的重要因素（p<0.001）。
我们的研究结果表明，康复治疗对功能改善有效，特别是在中重度TBI患者的早期，康复持续时间、早期康复、异位骨化和深静脉血栓形成也是功能改善的预测因素。
