Sakai Kotomi, Momosaki Ryo
Department of Rehabilitation Medicine, Setagaya Memorial Hospital, Tokyo, Japan.
Department of Dysphagia Rehabilitation, Nihon University School of Dentistry, Tokyo, Japan.
Prog Rehabil Med. 2016 Sep 30;1:20160004. doi: 10.2490/prm.20160004. eCollection 2016.
The purpose of this research was to investigate the real-world effectiveness of speech therapy time on cognitive recovery in older patients with acute stroke.
The participants of this retrospective cohort study were hospitalized patients with acute stroke registered in the Japan Rehabilitation Database between December 2005 and September 2014. The patients were divided into two groups according to the amount of time they spent undergoing speech therapy, i.e., a high-intensity speech therapy group and a control group. Multivariate linear regression analysis was performed to assess the association between cognitive Functional Independence Measure efficiency and high-intensity speech therapy.
Of the 3341 eligible stroke patients (mean age: 77 years) extracted from the database, 53% received high-intensity speech therapy. Patients in the high-intensity speech therapy group had significantly higher cognitive Functional Independence Measure efficiency scores than those in the control group (mean, 0.17 vs. 0.10, respectively; P < 0.001). Multivariate regression analysis showed that cognitive Functional Independence Measure efficiency was significantly and positively correlated with high-intensity speech therapy (coefficient, 0.03; 95% confidence interval, 0.004-0.056; P = 0.026).
These data suggest that a large amount of speech therapy time in older patients with acute stroke is a significant predictor of good cognitive recovery. Increased amounts of speech therapy for such patients may lead to better cognitive recovery after stroke.
本研究旨在调查言语治疗时长对急性中风老年患者认知恢复的实际效果。
这项回顾性队列研究的参与者为2005年12月至2014年9月期间登记在日本康复数据库中的急性中风住院患者。根据患者接受言语治疗的时长将其分为两组,即高强度言语治疗组和对照组。进行多变量线性回归分析以评估认知功能独立性测量效率与高强度言语治疗之间的关联。
从数据库中提取的3341例符合条件的中风患者(平均年龄:77岁)中,53%接受了高强度言语治疗。高强度言语治疗组患者的认知功能独立性测量效率得分显著高于对照组(分别为0.17和0.10;P<0.001)。多变量回归分析表明,认知功能独立性测量效率与高强度言语治疗显著正相关(系数为0.03;95%置信区间为0.004 - 0.056;P = 0.026)。
这些数据表明,急性中风老年患者大量的言语治疗时长是认知恢复良好的重要预测指标。增加此类患者的言语治疗时长可能会使中风后认知恢复更好。