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门诊心脏康复对脑卒中幸存者运动功能和健康相关生活质量的影响。

Effect of outpatient cardiac rehabilitation on motor function and health-related quality of life in stroke survivors.

机构信息

Department of Cerebral and Cardiovascular Rehabilitation, National Cerebral and Cardiovascular Center, Suita, Japan.

Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan.

出版信息

J Clin Neurosci. 2024 May;123:1-6. doi: 10.1016/j.jocn.2024.03.013. Epub 2024 Mar 19.

Abstract

BACKGROUND

Outpatient cardiac rehabilitation (CR) is a promising tool for improving functional outcome in stroke survivors, however, evidence for improving emotional health is limited. We aimed to clarify the effects of outpatient CR following in-hospital stroke rehabilitation on health-related quality of life (HRQOL) and motor function.

METHODS

Patients with acute ischemic stroke or transient ischemic attack discharged directly home were recruited, and 128 patients who fulfilled criteria for insurance coverage of CR were divided into the CR (+) group (n = 46) and CR (-) group (n = 82). All patients underwent in-hospital stroke rehabilitation, and within 2 months after stroke onset, patients in the CR (+) group started a 3-month outpatient CR program of supervised sessions. Changes of motor function and HRQOL assessed by the short form-36 version 2 (SF-36) from discharge to 3 months post-discharge were compared between the two groups.

RESULTS

Twenty-six patients in the CR (+) group completed the program and 66 patients in the CR (-) group were followed up at a 3-month examination. Least-square mean changes in 6-minute walk distance and isometric knee extension muscle strength were significantly higher in the CR (+) group than the CR (-) group (52.6 vs. 16.3 m; 10.1 vs. 3.50 kgf/kg). Improvement of HRQOL at 3 months was not observed in the CR (+) group.

CONCLUSIONS

Outpatient CR following in-hospital stroke rehabilitation within 2 months after stroke onset improved exercise tolerance and functional strength but not HRQOL assessed by the SF-36 after completion of CR in the present cohort.

摘要

背景

门诊心脏康复(CR)是改善中风幸存者功能结局的有前途的工具,但改善情绪健康的证据有限。我们旨在阐明住院中风康复后门诊 CR 对健康相关生活质量(HRQOL)和运动功能的影响。

方法

招募直接出院的急性缺血性中风或短暂性脑缺血发作患者,符合 CR 保险覆盖标准的 128 名患者分为 CR(+)组(n=46)和 CR(-)组(n=82)。所有患者均接受住院中风康复治疗,中风发病后 2 个月内,CR(+)组患者开始接受 3 个月的门诊 CR 监督治疗计划。比较两组患者从出院到出院后 3 个月时的运动功能和 SF-36 简表第 2 版(SF-36)评估的 HRQOL 变化。

结果

CR(+)组 26 名患者完成了该计划,CR(-)组 66 名患者在 3 个月检查时进行了随访。CR(+)组的 6 分钟步行距离和等长膝关节伸展肌力的最小二乘均数变化明显高于 CR(-)组(52.6 vs. 16.3 m;10.1 vs. 3.50 kgf/kg)。CR(+)组在 3 个月时 HRQOL 无改善。

结论

在中风发病后 2 个月内进行住院中风康复后的门诊 CR 可改善运动耐量和功能强度,但在本队列中完成 CR 后,SF-36 评估的 HRQOL 无改善。

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