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脑出血和脑梗死对脑卒中患者 ADL 和预后的影响:一项回顾性队列研究。

Impact of intracerebral hemorrhage and cerebral infarction on ADL and outcome in stroke patients: A retrospective cohort study.

机构信息

Department of Rehabilitation, Kyoto Rehabilitation Hospital, Kyoto, Japan.

Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan.

出版信息

NeuroRehabilitation. 2024;55(1):41-49. doi: 10.3233/NRE-240182.

Abstract

BACKGROUND

The impact of different stroke types on specific activities of daily living (ADL) is unclear.

OBJECTIVE

To investigate how differences between intracerebral hemorrhage (ICH) and cerebral infarction (CI) affect improvement of ADL in patients with stroke within a hospital by focusing on the sub-items of the Functional Independence Measure (FIM).

METHODS

Patients with first-stroke hemiplegia (n = 212) were divided into two groups: ICH (86 patients) and CI (126 patients). Primary assessments included 13 motor and 5 cognitive sub-items of the FIM assessed at admission and discharge. Between-group comparisons and multiple regression analyses were performed.

RESULTS

Upon admission, the ICH group exhibited significantly lower FIM scores than those of the CI group across various activities, including grooming, dressing (upper body and lower body), toileting, bed/chair transfer, toilet transfer, walking/wheelchair, and stairs. Age and FIM motor scores at admission influenced both groups' total FIM motor scores at discharge, whereas the duration from onset affected only the CI group.

CONCLUSION

Several individual FIM motor items were more adversely affected by ICH than by CI. Factors related to ADL at discharge may differ depending on stroke type. Recognizing these differences is vital for efficient rehabilitation practices and outcome prediction.

摘要

背景

不同类型的中风对特定日常生活活动(ADL)的影响尚不清楚。

目的

通过关注功能独立性测量(FIM)的子项目,调查脑出血(ICH)和脑梗死(CI)之间的差异如何影响中风患者在医院内 ADL 的改善,以专注于特定的 ADL 子项目。

方法

将 212 例首次发生偏瘫的中风患者分为两组:ICH(86 例)和 CI(126 例)。主要评估包括入院和出院时 FIM 的 13 项运动和 5 项认知子项目。进行组间比较和多元回归分析。

结果

入院时,ICH 组在各种活动(包括梳头、穿衣(上身和下身)、上厕所、床/椅转移、厕所转移、行走/轮椅和楼梯)中的 FIM 评分明显低于 CI 组。入院时的年龄和 FIM 运动评分影响两组出院时的总 FIM 运动评分,而发病时间仅影响 CI 组。

结论

与 CI 相比,ICH 对几个单独的 FIM 运动项目的影响更为不利。与出院时 ADL 相关的因素可能因中风类型而异。认识到这些差异对于有效的康复实践和预后预测至关重要。

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