上肢干针疗法在脑卒中患者康复中的成本效益。
Cost-effectiveness of upper extremity dry needling in the rehabilitation of patients with stroke.
机构信息
Universidad San Jorge, Zaragoza, Spain.
Servicio de Rehabilitación, Hospital Guadarrama, Madrid, Spain.
出版信息
Acupunct Med. 2022 Apr;40(2):160-168. doi: 10.1177/09645284211055750. Epub 2021 Dec 2.
INTRODUCTION
Dry needling (DN) has been shown to be effective for the treatment of upper extremity hypertonia in patients with stroke.
PURPOSE
To evaluate the cost-effectiveness of DN in patients with stroke.
METHODS
A cost-effectiveness analysis was performed in a research study conducted at a Spanish public hospital where patients were classified into two groups with or without DN. Hypertonia was measured using the Modified Modified Ashworth Scale (MMAS), and quality of life (QOL) was assessed using the EuroQoL 5-dimension questionnaire. Data regarding the effects and costs of physiotherapy were presented by calculating the mean and 95% confidence interval. The health outcomes were evaluated considering the rate of responders to the treatment based on the MMAS. Spanish preference weights were used to estimate quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR) were calculated to determine the economic value of DN.
RESULTS
Eighty patients with stroke in the subacute stage of recovery were selected to participate in this study. Based on the rate of responders, the ICER of the DN group was very low. Despite the sensitivity analysis performed, the results of the ICUR were not encouraging.
DISCUSSION
Cost-effectiveness with responder rate results were favourable for the DN group and were confirmed by the sensitivity analysis according to levels of care. In addition, our findings revealed that 4 weeks of treatment could be more cost-effective than 8 weeks. DN treatment of the upper extremity appears to be cost-effective based on the rate of responders measured using the MMAS scale.
简介
干针疗法(DN)已被证明对治疗中风患者上肢痉挛有效。
目的
评估 DN 在中风患者中的成本效益。
方法
在西班牙一家公立医院进行的研究中进行了成本效益分析,将患者分为有或没有 DN 的两组。采用改良改良 Ashworth 量表(MMAS)测量痉挛程度,采用欧洲五维健康量表(EuroQoL 5-dimension questionnaire)评估生活质量(QOL)。通过计算平均值和 95%置信区间,报告了物理治疗效果和成本的数据。健康结果根据 MMAS 评估治疗的应答率进行评估。使用西班牙偏好权重来估计质量调整生命年(QALYs)。计算增量成本效益比(ICER)和增量成本效用比(ICUR),以确定 DN 的经济价值。
结果
从亚急性期恢复的 80 名中风患者被选入本研究。根据应答率,DN 组的 ICER 非常低。尽管进行了敏感性分析,但 ICUR 的结果并不理想。
讨论
根据应答率的成本效益结果对 DN 组有利,并根据护理水平的敏感性分析得到证实。此外,我们的研究结果表明,4 周的治疗可能比 8 周的治疗更具成本效益。根据 MMAS 量表测量的应答率,DN 治疗上肢似乎具有成本效益。