Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm.
Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm; Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden.
J Rehabil Med. 2022 Jun 20;54:jrm00291. doi: 10.2340/jrm.v54.1060.
To compare changes in the perceived impact of stroke on everyday life over time in a rehabilitation sample that received a client-centred activities of daily living (CADL) intervention or usual ADL (UADL) intervention.
Longitudinal follow-up of a randomized controlled trial.
A total of 145 persons with stroke were assigned into CADL or UADL. Groups were assessed using the Stroke Impact Scale (SIS) at 3 months, 12 months and 5 years post-intervention. Changes in SIS domain scores over time were compared within and between groups.
Changes in the impact of stroke over time were not related to which intervention the groups received. There were no significant differences in the SIS domains or stroke recovery between groups at the 3-month, 12-month and 5-year follow-ups. Despite an increased impact of stroke over time in some domains in both groups, both groups perceived a decreased impact of stroke in the Participation domain at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups.
These findings stress the importance of access to follow-up rehabilitation interventions 1-year post-stroke to enable participation in daily activities. Such follow-up and enablement would support the use of self-management strategies in the performance of persons' valued activities, which might be difficult to perform, due to, for example, impact on hand function or mobility. The results of this study emphasize the importance of prioritizing participation in activities that are meaningful from a personal perspective.
比较接受以患者为中心的日常生活活动（CADL）干预或常规日常生活活动（UADL）干预的康复样本中，随着时间推移对中风日常生活影响的感知变化。
一项随机对照试验的纵向随访。
共纳入 145 名中风患者，分为 CADL 组或 UADL 组。两组均在干预后 3 个月、12 个月和 5 年使用中风影响量表（SIS）进行评估。比较组内和组间随时间变化的 SIS 域评分变化。
随着时间推移，中风影响的变化与组间接受的干预无关。在 3 个月、12 个月和 5 年随访时，两组间 SIS 各域评分或中风恢复均无显著差异。尽管两组各域中风的影响随时间增加，但两组在 12 个月时均感知到参与度的影响降低。两组在 12 个月时的参与度与 5 年时相同。
这些发现强调了中风后 1 年接受随访康复干预的重要性，以实现日常活动的参与。这种随访和启用将支持在患者进行有价值的活动时使用自我管理策略，由于对手部功能或移动性的影响等原因，这些活动可能难以进行。本研究结果强调了优先考虑从个人角度参与有意义的活动的重要性。
