Lo Yi-Pang, Wang Mei-Chen, Chen Yao-Hsiang, Chiang Shang-Lin, Lin Chia-Huei
Department of Nursing, Tri-Service General Hospital Songshan Branch, Taipei 10581, Taiwan.
Graduate Institute of Medical Sciences, College of Medicine, National Defense Medical University, Taipei 11490, Taiwan.
Life (Basel). 2025 Aug 1;15(8):1216. doi: 10.3390/life15081216.
Early rehabilitation is essential for restoring functional recovery in patients with stroke, particularly during the early phase of post-acute care (PAC), or the subacute stage. We aimed to evaluate the effectiveness of a 7-week PAC rehabilitation program in improving muscle strength, physical performance, and functional recovery. A total of 219 inpatients with stroke in the subacute stage were initially recruited from the PAC ward of a regional teaching hospital in Northern Taiwan, with 79 eligible patients-within 1 month of an acute stroke-included in the analysis. The program was delivered 5 days per week, with 3-4 sessions daily (20-30 min each, up to 120 min daily), comprising physical, occupational, and speech-language therapies. Sociodemographic data, muscle strength, physical performance (Berg Balance Scale [BBS], gait speed, and 6-minute walk test [6MWT]), and functional recovery (modified Rankin Scale [mRS], Barthel Index [BI], Instrumental Activities of Daily Living [IADL], and Fugl-Meyer assessment: sensory and upper extremity) were collected at baseline, 3 weeks, and 7 weeks. Generalized estimating equations analyzed program effectiveness. Among the 56 patients (70.9%) who completed the program, significant improvements were observed in the muscle strength of both the affected upper (B = 0.93, < 0.001) and lower limbs (B = 0.88, < 0.001), as well as in their corresponding unaffected limbs; in physical performance, including balance (BBS score: B = 9.70, = 0.003) and gait speed (B = 0.23, = 0.024); and in functional recovery, including BI (B = 19.5, < 0.001), IADL (B = 1.48, < 0.001), and mRS (B = -0.13, = 0.028). These findings highlight the 7-week PAC rehabilitation program as an effective strategy during the critical recovery phase for patients with stroke.
早期康复对于脑卒中患者恢复功能至关重要，尤其是在急性后期护理（PAC）的早期阶段，即亚急性期。我们旨在评估一项为期7周的PAC康复计划在改善肌肉力量、身体机能和功能恢复方面的效果。最初从台湾北部一家地区教学医院的PAC病房招募了219名亚急性期脑卒中住院患者，分析纳入了79名符合条件的患者（急性脑卒中后1个月内）。该计划每周实施5天，每天进行3 - 4节治疗（每节20 - 30分钟，每天最多120分钟），包括物理治疗、职业治疗和言语治疗。在基线、3周和7周时收集社会人口学数据、肌肉力量、身体机能（伯格平衡量表[BBS]、步速和6分钟步行试验[6MWT]）以及功能恢复情况（改良Rankin量表[mRS]、Barthel指数[BI]、日常生活活动能力量表[IADL]和Fugl - Meyer评估：感觉和上肢）。采用广义估计方程分析该计划的效果。在完成该计划的56名患者（70.9%）中，观察到患侧上肢（B = 0.93，<0.001）和下肢（B = 0.88，<0.001）以及相应未受影响肢体的肌肉力量均有显著改善；身体机能方面，包括平衡能力（BBS评分：B = 9.70，=0.003）和步速（B = 0.23，=0.024）；功能恢复方面，包括BI（B = 19.5，<0.001）、IADL（B = 1.48，<0.001）和mRS（B = -0.13，=0.028）。这些发现突出了为期7周的PAC康复计划是脑卒中患者关键恢复阶段的有效策略。
