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[亚急性脑卒中患者接受多学科康复治疗后的姿势控制与步态变化及相关因素:一项回顾性研究]

[Postural control and gait changes in subacute stroke patients after receiving interdisciplinary rehabilitation and related factors: a retrospective study].

作者信息

Arranz-Escudero A, Martín-Casas P, Díaz-Arribas M J, Carpio-Calatayud E, Niño-Díaz G, López-de-Uralde-Villanueva I

机构信息

Universidad Complutense de Madrid, Madrid, España.

Universidad Complutense de Madrid., Madrid, España.

出版信息

Rev Neurol. 2021 Dec 1;73(11):383-389. doi: 10.33588/rn.7311.2021347.

DOI:10.33588/rn.7311.2021347
PMID:34826331
Abstract

INTRODUCTION

Although early post-stroke rehabilitation is essential to optimize recovery, its effects and prognostic factors are yet under discussion.

OBJECTIVE

To assess postural control and gait changes in post-stroke patients who underwent interdisciplinary rehabilitation in subacute phase and evaluate potential associated factors.

PATIENTS AND METHODS

An observational retrospective study that analyzed sociodemographic and clinical data, including Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulatory Categories (FAC) and Tinetti scale, at admission and two months after rehabilitation.

RESULTS

Data were collected from 63 patients with stroke in subacute phase. Interdisciplinary rehabilitation had a moderate and relevant clinical impact (p < 0,01; d mayor de 0,5) in postural control and gait. Ambulatory rehabilitation, psychotropic medication absence and dislipemia absence were moderate associated factors (p < 0,05; d mayor de 0,5) with a greater evolution in postural control measured with TIS and PASS. TIS at admission showed significant association with all scales' results at two months after rehabilitation, except with PASS changing posture subscale.

CONCLUSIONS

Interdisciplinary rehabilitation promotes moderate and clinically relevant changes in postural control and gait recovery in subacute stroke patients, after two-month rehabilitation period. Ambulatory rehabilitation, dyslipidemia absence and psychotropic medication absence were associated with patients' evolution, but further research is required to confirm their actual influence in larger samples.

摘要

引言

尽管中风后早期康复对于优化恢复至关重要,但其效果和预后因素仍在讨论中。

目的

评估在亚急性期接受多学科康复治疗的中风患者的姿势控制和步态变化,并评估潜在的相关因素。

患者与方法

一项观察性回顾性研究,分析了入院时以及康复后两个月的社会人口统计学和临床数据,包括躯干损伤量表(TIS)、中风姿势评估量表(PASS)、功能性步行分类(FAC)和Tinetti量表。

结果

收集了63例亚急性期中风患者的数据。多学科康复对姿势控制和步态有中度且显著的临床影响(p < 0.01;d大于0.5)。步行康复、无精神药物治疗和无血脂异常是与TIS和PASS测量的姿势控制方面更大进展中度相关的因素(p < 0.05;d大于0.5)。入院时的TIS与康复后两个月时所有量表的结果均有显著关联,但与PASS改变姿势子量表无关。

结论

经过两个月的康复期后,多学科康复促进了亚急性中风患者姿势控制和步态恢复的中度且具有临床意义的变化。步行康复、无血脂异常和无精神药物治疗与患者的进展相关,但需要进一步研究以证实它们在更大样本中的实际影响。

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