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卒中患者出院时与步行独立性相关因素的纵向变化:一项回顾性研究

Longitudinal Changes in Factors Associated with Walking Independence at Hospital Discharge in Patients with Stroke: A Retrospective Study.

作者信息

Yamamoto Ryosuke, Murata Shin, Sawai Shun, Fujikawa Shoya, Shizuka Yusuke, Maru Takayuki, Nakagawa Kotaro, Nakano Hideki

机构信息

Graduate School of Health Sciences, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto-shi 607-8175, Kyoto, Japan.

Department of Rehabilitation, Tesseikai Neurosurgical Hospital, 28-1 Nakanohon-Machi, Shijonawate-shi 575-8511, Osaka, Japan.

出版信息

J Clin Med. 2024 Nov 27;13(23):7184. doi: 10.3390/jcm13237184.

Abstract

: Patients with stroke usually have long-term residual gait disability. However, temporal changes in factors associated with gait independence in these patients at the time of hospital discharge have not been clarified. This study aimed to determine changes over time in factors associated with gait independence in patients with stroke at the time of hospital discharge. This would predict that factors associated with the level of walking independence in patients with stroke at discharge from the hospital would show different results depending on the changes over time post-stroke onset. : This retrospective observational study used data from the medical records of patients with stroke with unilateral supratentorial lesions who were admitted and rehabilitated at Tesseikai Neurosurgical Hospital between October 2020 and July 2024. The Functional Ambulation Category (FAC), Stroke Impairment Assessment Set-lower extremity motor items, Trunk Control Test, Mini-Balance Evaluation Systems Test (Mini-BESTest), and Functional Independence Measure cognitive items were assessed monthly for 3 months post-stroke onset. Participants were classified into independent and non-independent walking groups using the FAC. Logistic regression analysis was performed with walking independence at discharge and other assessment indicators as the dependent and independent variables, respectively, to identify factors influencing walking independence at discharge. Independent variables were entered by month from 1 to 3 months. : Logistic regression analysis revealed that Mini-BESTest scores at 2 and 3 months post-stroke onset were significantly associated with walking independence at discharge ( < 0.05). : This study suggests the importance of assessing the Mini-BESTest scores over time, starting at 2 months post-stroke onset, when determining walking independence in patients with stroke. Providing balance training to patients with low Mini-BESTest scores between 1 and 3 months post-stroke onset may contribute to improved walking independence at discharge.

摘要

中风患者通常存在长期的残余步态残疾。然而,这些患者出院时与步态独立性相关的因素随时间的变化尚未明确。本研究旨在确定中风患者出院时与步态独立性相关的因素随时间的变化。这将预测,中风发病后,出院时中风患者步行独立水平相关的因素会因时间变化而呈现不同结果。 :这项回顾性观察研究使用了2020年10月至2024年7月在Tesseikai神经外科医院住院并接受康复治疗的单侧幕上病变中风患者的病历数据。在中风发病后的3个月内,每月评估功能步行分类(FAC)、中风损伤评估量表-下肢运动项目、躯干控制测试、迷你平衡评估系统测试(Mini-BESTest)和功能独立性测量认知项目。使用FAC将参与者分为独立步行组和非独立步行组。分别以出院时的步行独立性和其他评估指标作为因变量和自变量进行逻辑回归分析,以确定影响出院时步行独立性的因素。自变量按发病后1至3个月逐月输入。 :逻辑回归分析显示,中风发病后2个月和3个月时的Mini-BESTest评分与出院时的步行独立性显著相关(<0.05)。 :本研究表明,在确定中风患者的步行独立性时,从中风发病后2个月开始随时间评估Mini-BESTest评分具有重要意义。对中风发病后1至3个月Mini-BESTest评分较低的患者提供平衡训练可能有助于提高出院时的步行独立性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28b/11642267/d05fcae4ea82/jcm-13-07184-g001.jpg

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