Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Japan,Department of Rehabilitation Therapy, Tsukuba Medical Center Hospital, Tsukuba, Japan.
Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000028974.
Excessive assistance may decrease stroke patients' physical activity and make them more dependent on assistance. We have structured a system that provides an ADL (activities of daily living) educational program that focuses on stroke patients' toileting in our daily clinical practice. Here, we investigated the effect of a functional independence measure (FIM) scale on the recovery of patients with acute stroke.We retrospectively collected the data of 407 stroke patients from the medical record system of our emergency hospital in Tsukuba, Japan. The enrolled stroke patients (n = 373) were divided into FIM and control groups. Both groups received the standard treatment, but for the FIM group, ward and rehabilitation staff calculated the toilet FIM score for patients 1 ×/wk. The FIM scale measures the amount of assistance a patient needs to perform activities of daily living and is often used in rehabilitation settings. The rehabilitation staff then instructed the ward staff about better assistance methods based on each patient's physical function and executive dysfunction. We evaluated the usefulness of the FIM scale was based on the patients' FIM scores at discharge and improvements in their scores.The recoveries of the total, motor, and cognitive FIM scores recovery at discharge were significantly greater in the FIM group compared with the control group (68.0 vs 45.0, P = .004; 41.0 vs 24.0, P = .005; and 24.0 vs 20.0, P = .007, respectively). The use of the FIM scale contributes to the patients' recovery of physical function and cognitive function.The FIM scale can contribute to stroke patients' recovery of activities of daily living.
过度的辅助可能会降低中风患者的身体活动能力，并使他们更加依赖辅助。我们在日常临床实践中构建了一个系统，提供了一个日常生活活动（ADL）教育计划，重点是中风患者的如厕问题。在这里，我们调查了功能独立性测量（FIM）量表对急性中风患者康复的影响。我们从日本筑波市我们的急诊医院的病历系统中回顾性地收集了 407 名中风患者的数据。纳入的中风患者（n=373）分为 FIM 组和对照组。两组均接受标准治疗，但 FIM 组的病房和康复工作人员每周为患者计算一次厕所 FIM 评分。FIM 量表用于测量患者进行日常生活活动所需的帮助量，常用于康复环境中。康复工作人员根据每个患者的身体功能和执行功能障碍，向病房工作人员介绍更好的辅助方法。我们根据患者出院时的 FIM 评分以及评分的改善来评估 FIM 量表的有用性。与对照组相比，FIM 组出院时的总 FIM、运动 FIM 和认知 FIM 评分的恢复显著更高（68.0 对 45.0，P=0.004；41.0 对 24.0，P=0.005；24.0 对 20.0，P=0.007）。FIM 量表的使用有助于患者身体功能和认知功能的恢复。FIM 量表有助于中风患者日常生活活动的恢复。
