Wang Heng, Zhu Yuping, Xiong Ping, Liu Ming
Department of Neurology, Wuhan University People's Hospital, Wuhan, Hubei Province, China.
Department of NeuroSurgery, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongii Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, China.
Medicine (Baltimore). 2025 Jul 18;104(29):e43139. doi: 10.1097/MD.0000000000043139.
This study evaluates the impact of an information-motivation-behavioral skills model (IMB model) health education intervention combined with feedback on rehabilitation outcomes for ischemic stroke patients with hemiplegia, targeting improvements in motor function, psychological state, disease awareness, and quality of life. A total of 152 ischemic stroke patients with hemiplegia were divided into an experimental group receiving the IMB-based intervention and a control group receiving standard education. Both interventions lasted 3 months. Rehabilitation outcomes were measured using indicators such as Fugl-Meyer assessment (FMA) for limb motor function, Activities of Daily Living (ADL) Scale, Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) for psychological status, disease cognition, and compliance. The experimental group showed significantly better improvements across all indicators. FMA scores increased notably in the experimental group (58.12 ± 2.22) versus the control (53.65 ± 3.01, P < .001). Activities of Daily Living scores also improved more in the experimental group (79.36 ± 8.36) compared to the control (71.95 ± 7.71, P < .001). Psychological assessments indicated greater HAMA and HAMD score reductions in the experimental group (HAMA: 13.56 ± 2.74 vs 15.26 ± 2.09; HAMD: 15.21 ± 1.98 vs 18.36 ± 1.98, both P < .001). Disease awareness and compliance were higher in the experimental group (P < .05), and stroke-specific quality of life scores were also superior (192.36 ± 18.69 vs 179.36 ± 21.69, P < .001). Additionally, the experimental group experienced fewer complications like spasticity and contractures (P = .002). The IMB-based intervention with feedback shows notable benefits for ischemic stroke patients with hemiplegia, enhancing compliance, motor function, and quality of life. Future research should explore larger samples and longer follow-up to verify long-term effects.
本研究评估了信息 - 动机 - 行为技能模型（IMB模型）健康教育干预结合反馈对缺血性脑卒中偏瘫患者康复结局的影响，旨在改善运动功能、心理状态、疾病认知和生活质量。总共152例缺血性脑卒中偏瘫患者被分为接受基于IMB干预的实验组和接受标准教育的对照组。两种干预均持续3个月。使用诸如肢体运动功能的Fugl - Meyer评估（FMA）、日常生活活动（ADL）量表、汉密尔顿焦虑评定量表（HAMA）、汉密尔顿抑郁评定量表（HAMD）等指标来测量心理状态、疾病认知和依从性等康复结局。实验组在所有指标上均显示出明显更好的改善。实验组的FMA评分显著提高（58.12±2.22），而对照组为（53.65±3.01，P <.001）。与对照组（71.95±7.71，P <.001）相比，实验组的日常生活活动评分也有更大改善（79.36±8.36）。心理评估表明，实验组的HAMA和HAMD评分降低幅度更大（HAMA：13.56±2.74对15.26±2.09；HAMD：15.21±1.98对18.36±1.98，均P <.001）。实验组的疾病认知和依从性更高（P <.05），且脑卒中特异性生活质量评分也更高（192.36±18.69对179.36±21.69，P <.001）。此外，实验组出现痉挛和挛缩等并发症的情况较少（P = 0.002）。基于IMB的干预结合反馈对缺血性脑卒中偏瘫患者显示出显著益处，可提高依从性、运动功能和生活质量。未来研究应探索更大样本和更长随访时间以验证长期效果。
