Wade D T, Wood V A, Hewer R L
J Neurol Neurosurg Psychiatry. 1985 Jan;48(1):7-13. doi: 10.1136/jnnp.48.1.7.
Ninety-nine patients had their function recorded regularly over the first 13 weeks after their stroke. Five functional areas were studied: urinary continence, mobility, the ability to dress, feeding, and the ability to transfer from bed to chair. Thirty-two patients died before 13 weeks. Forty-five of the 67 survivors had assessments twice weekly from within 4 days of their stroke. Recovery in these 45 patients occurred fastest in the first 2 weeks, by which time at least 50% of recovery had occurred, but it was still continuing at 13 weeks. Urinary incontinence present between 7 and 10 days after stroke was the most important adverse prognostic factor both for survival and for recovery of function. Age was the second most important factor. Hospital discharge seemed to occur once recovery had stopped, although four of the 49 patients discharged had been fully independent for at least 12 days prior to discharge. It is suggested that rehabilitative therapy should concentrate less on physical function and more on cognitive ability.
99名患者在中风后的前13周内接受了定期的功能记录。研究了五个功能领域:尿失禁、活动能力、穿衣能力、进食能力以及从床转移到椅子的能力。32名患者在13周前死亡。67名幸存者中的45名在中风后4天内每周接受两次评估。这45名患者的恢复在最初2周内最快,到那时至少50%的恢复已经发生,但在13周时仍在继续。中风后7至10天出现的尿失禁是生存和功能恢复最重要的不良预后因素。年龄是第二重要的因素。出院似乎发生在恢复停止之后,尽管49名出院患者中有4名在出院前至少12天已经完全独立。建议康复治疗应减少对身体功能的关注,更多地关注认知能力。