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影响亚急性脑卒中患者康复意愿的因素。

Factors influencing the willingness to participate in rehabilitation in patients with subacute stroke.

机构信息

Department of Physical Medicine & Rehabilitation, Ankara Etlik City Hospital, Ankara, Turkey.

Department of Physical Medicine & Rehabilitation, Ankara Etlik City Hospital, Ankara, Turkey.

出版信息

J Clin Neurosci. 2023 Oct;116:99-103. doi: 10.1016/j.jocn.2023.09.001. Epub 2023 Sep 6.

Abstract

OBJECTIVE

The aim of this study was to examine the parameters that may influence the willingness of patients to participate in post-stroke rehabilitation.

METHODS

Patients in the subacute phase of stroke who underwent inpatient rehabilitation for one month were included in this study. The primary outcome measure was the level of rehabilitation participation as measured on the Pittsburgh Rehabilitation Participation Scale (PRPS). Other outcome measures evaluated were Mini-Mental State Examination (MMSE) for cognitive functions, Brunnstrom stage for motor recovery, modified Rankin Scale (mRS) for disability, Functional Independence Measure for functionality, Pittsburgh Sleep Quality Index for sleep quality, and Beck Depression Inventory for emotional state.

RESULTS

A total of 38 patients with first-time stroke were studied. A negative correlation was found between the participation in rehabilitation and body mass index (BMI) (r: -0.398p = 0.012), myocardial infarction (MI) history (r: -0.387p = 0.015) and mRS (r: -0.351p = 0.031), while a positive correlation was determined with MMSE (r: 0.432P = 0.007). A 1-unit increase in BMI, MI history, and mRS resulted in a 0.176, 0.673, and 0.294-unit decrease in participation in rehabilitation, respectively. In addition, a 1-unit increase in MMSE provided an increase of 0.606-unit in participation.

CONCLUSION

BMI within normal limits, prevention/treatment of cardiovascular diseases, and well-being of physical and cognitive functions might be the factors that positively influence participation in rehabilitation process. We consider that it would be appropriate to evaluate these parameters with particular emphasis in stroke patients in the subacute period to be rehabilitated.

摘要

目的

本研究旨在探讨可能影响患者参与卒中后康复意愿的因素。

方法

本研究纳入了接受为期一个月住院康复治疗的亚急性期卒中患者。主要结局测量指标为采用匹兹堡康复参与量表(PRPS)评估的康复参与度。其他评估指标包括认知功能的简易精神状态检查(MMSE)、运动恢复的 Brunnstrom 分期、残疾的改良 Rankin 量表(mRS)、功能独立性测量的功能、睡眠质量的匹兹堡睡眠质量指数和情绪状态的贝克抑郁量表。

结果

共研究了 38 例首次卒中患者。发现康复参与度与体重指数(BMI)(r:-0.398,p=0.012)、心肌梗死(MI)病史(r:-0.387,p=0.015)和 mRS(r:-0.351,p=0.031)呈负相关,而与 MMSE 呈正相关(r:0.432,P=0.007)。BMI、MI 病史和 mRS 每增加 1 个单位,康复参与度分别减少 0.176、0.673 和 0.294 个单位。此外,MMSE 每增加 1 个单位,参与度增加 0.606 个单位。

结论

正常范围内的 BMI、心血管疾病的预防/治疗以及身体和认知功能的健康可能是积极影响康复参与度的因素。我们认为,在亚急性期接受康复治疗的卒中患者中,评估这些参数是合适的。

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