研究强化住院康复后居家康复对运动功能、日常生活活动能力及照顾者负担的影响。

Investigating the effects of home-based rehabilitation after intensive inpatient rehabilitation on motor function, activities of daily living, and caregiver burden.

作者信息

Sato Kenji, Otaka Eri, Ozaki Kenichi, Shiramoto Kenta, Narukawa Rie, Kamiya Takeshi, Kamiya Masaki, Shimotori Daiki, Kamizato Chiaki, Itoh Naoki, Kagaya Hitoshi, Kondo Izumi

机构信息

Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.

Laboratory of Practical Technology in Community, Assistive Robot Center, National Center for Geriatrics and Gerontology Research Institute, Obu, Aichi, Japan.

出版信息

PLoS One. 2024 Dec 27;19(12):e0316163. doi: 10.1371/journal.pone.0316163. eCollection 2024.

DOI:10.1371/journal.pone.0316163

PMID:39729469

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11676825/

Abstract

BACKGROUND

Home-based rehabilitation involves professional rehabilitation care and guidance offered by physical, occupational, and speech therapists to patients in their homes to help them recuperate in a familiar living environment. The effects on the patient's motor function and activities of daily living (ADLs), and caregiver burden for community-dwelling patients are well-documented; however, little is known about the immediate benefits in patients discharged from the hospital. Therefore, we examined the effects of continuous home-based rehabilitation immediately after discharge to patients who received intensive rehabilitation during hospitalization.

METHODS

We retrospectively reviewed 150 patients [mean (standard deviation, SD) = 81 (9) years] discharged from the convalescent rehabilitation and community-based integrated care wards undergoing tailored home-based rehabilitation for 6 months (provided by physical or occupational therapists: 1-2 sessions of 40-60 min each per week). The outcome measures at baseline and after 3 and 6 months were compared.

RESULTS

The participants included in this study had orthopedic (n = 76), cerebrovascular (n = 50), neuromuscular (n = 11), cardiovascular (n = 5), respiratory (n = 3), cancer (n = 3) and other diseases (n = 2). The mean (SD) time from discharge to the start of rehabilitation was 4 (4) days. One-way analysis of variance and post-hoc comparisons showed significant improvements at 3 months from baseline in grip strength (p = 0.002), 5-repetition sit-to-stand test (p < 0.001), Standing test for Imbalance and Disequilibrium test (p = 0.025), Functional Independence Measure (p < 0.001), modified Frenchay Activities Index (p < 0.001). Additionally, a statistically significant improvement was observed in the Japanese Zarit Caregiver Burden Interview score at 6 months from baseline (p < 0.001).

CONCLUSIONS

Home-based rehabilitation improves motor function, ADLs, and instrumental ADLs even after intensive inpatient rehabilitation and decreases the burden of the caregiver in the long term. Hence, tailored home-based rehabilitation should be continuously implemented after the completion of intensive inpatient rehabilitation.

摘要

背景

居家康复是指物理治疗师、职业治疗师和言语治疗师在患者家中提供专业的康复护理和指导，帮助他们在熟悉的生活环境中康复。居家康复对社区居住患者的运动功能、日常生活活动能力（ADL）以及照顾者负担的影响已有充分记录；然而，对于出院患者的即时益处却知之甚少。因此，我们研究了对住院期间接受强化康复治疗的患者出院后立即进行持续居家康复的效果。

方法

我们回顾性分析了150例患者[平均（标准差，SD）=81（9）岁]，这些患者从康复疗养和社区综合护理病房出院后接受了为期6个月的定制居家康复治疗（由物理治疗师或职业治疗师提供：每周1 - 2次，每次40 - 60分钟）。比较了基线时以及3个月和6个月后的结局指标。

结果

本研究纳入的参与者患有骨科疾病（n = 76）、脑血管疾病（n = 50）、神经肌肉疾病（n = 11）、心血管疾病（n = 5）、呼吸系统疾病（n = 3）、癌症（n = 3）和其他疾病（n = 2）。从出院到开始康复的平均（SD）时间为4（4）天。单因素方差分析和事后比较显示，与基线相比，3个月时握力（p = 0.002）、5次坐立试验（p < 0.001）、站立平衡和失衡试验（p = 0.025）、功能独立性测量（p < 0.001）、改良Frenchay活动指数（p < 0.001）有显著改善。此外，与基线相比，6个月时日本Zarit照顾者负担访谈评分有统计学意义的改善（p < 0.001）。