Sahoo Pabitra Kumar, Nehal Nehal
Physical Medicine and Rehabilitation, Swami Vivekanand National Institute of Rehabilitation Training and Research (SVNIRTAR), Bairoi, IND.
Physical Medicine and Rehabilitation, Healthway Hospital Old Goa, Bainguinim, IND.
Cureus. 2022 Dec 27;14(12):e33002. doi: 10.7759/cureus.33002. eCollection 2022 Dec.
Background The concept of focused rehabilitative care and a dedicated rehabilitation setup is fairly less known among the people of developing countries. The main objective of the study is to assess the effect of late-onset stroke rehabilitation on its overall prognosis and to see whether and how the late initiation of rehabilitation would pose a significant effect on functional recovery and adverse medical outcomes Methods A single-center, prospective observational study was conducted in a tertiary rehabilitation center for a duration of one and a half years. The subjects admitted to the Department of Physical Medicine and Rehabilitation were divided into three groups with respect to the onset to admission interval (OAI). Patients who got admitted within 30 days (OAI≤ 30 days) were considered the early rehabilitation group. OAI between 31 and 150 days was the late rehabilitation group and OAI of 151 days or more was the very late rehabilitation group. Barthel Index (BI), Modified Rankin Score (MRS), and 6-minute walk test (6MWT) were used as functional outcome measures at admission and discharge from indoors. Results Maximum complications were observed in the late rehabilitation group, i.e. 2.75±2.74, with an overall mean of 2.02±2.04 (p=0.003). Functional recovery assessed using BI shows a significant difference between the early (35.79±8.86) and late (40.62±10.5) rehabilitation groups (p= 0.0005). 6MWT at discharge showed significant improvement in the early rehabilitation group (p=0.005). Conclusion Early onset of rehabilitation showed better functional recovery and fewer adverse medical outcomes in stroke patients. A longer length of hospital stay (LOHS), with a mean duration of 88 ±2 days was needed for patients with higher OAIs.
在发展中国家，人们对集中康复护理和专门康复设施的概念了解较少。本研究的主要目的是评估迟发性中风康复对其总体预后的影响，并探讨康复开始时间较晚是否以及如何对功能恢复和不良医疗结局产生重大影响。方法：在一家三级康复中心进行了一项单中心前瞻性观察研究，为期一年半。根据入院间隔时间（OAI），将入住物理医学与康复科的患者分为三组。入院30天内（OAI≤30天）入院的患者被视为早期康复组。OAI在31至150天之间为晚期康复组，OAI为151天及以上为极晚期康复组。采用Barthel指数（BI）、改良Rankin评分（MRS）和6分钟步行试验（6MWT）作为入院时和室内出院时的功能结局指标。结果：晚期康复组观察到的并发症最多，即2.75±2.74，总体平均为2.02±2.04（p=0.003）。使用BI评估的功能恢复显示，早期（35.79±8.86）和晚期（40.62±10.5）康复组之间存在显著差异（p=0.0005）。出院时的6MWT显示早期康复组有显著改善（p=0.005）。结论：中风患者早期开始康复显示出更好的功能恢复和更少的不良医疗结局。OAI较高的患者需要更长的住院时间（LOHS），平均持续时间为88±2天。
