Haig A J, Nagy A, LeBreck D B, Stein G L
Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, USA.
Arch Phys Med Rehabil. 1995 Apr;76(4):341-8. doi: 10.1016/s0003-9993(95)80659-8.
The purposes of this study were to assess the effect of adding a physiatrist to the usual community management of persons with complex disabilities, and to determine whether there were differences in decision making and patient outcome between evaluations by a physiatrist alone or with a multidisciplinary team in this population. Consecutively referred patients with functional complaints in two of the following areas, mobility, activities of daily living, emotions and cognition, work, or social support, were randomly assigned to a multidisciplinary outpatient team evaluation or physiatrist evaluation in an office setting. Forty persons, 21 team and 19 office, served as subjects. For the entire group, functional assessment scores before and after evaluation were as follows: Barthel index 71.79 versus 76.47 (p < .008) and Frenchay Activities index 9.97 versus 11.32 (p < .05) Wilcoxon Signed Ranks test. Patients quality of life differences were significant (p < .03 or less by Wilcoxon). Most differences between team and physiatrist were not shown to be statistically significant in this small population. Physiatric evaluation, with or without a multidisciplinary team, can improve outpatient functional status and quality of life for persons living in the community with complex disabilities.
本研究的目的是评估在对复杂残疾患者的常规社区管理中增加一名物理治疗师的效果，并确定在该人群中，由物理治疗师单独评估或与多学科团队一起评估时，决策和患者预后是否存在差异。连续转诊的、在以下两个领域存在功能障碍主诉的患者，即移动性、日常生活活动、情绪和认知、工作或社会支持，被随机分配到多学科门诊团队评估或在办公室环境中由物理治疗师进行评估。40名患者，21名接受团队评估，19名接受办公室评估，作为研究对象。对于整个研究组，评估前后的功能评估得分如下：Barthel指数从71.79提高到76.47（p < 0.008），Frenchay活动指数从9.97提高到11.32（p < 0.05）（Wilcoxon符号秩检验）。患者的生活质量差异显著（Wilcoxon检验p < 0.03或更低）。在这个小样本中，团队评估和物理治疗师评估之间的大多数差异未显示出统计学意义。无论有无多学科团队参与，物理治疗师评估都可以改善社区中复杂残疾患者的门诊功能状态和生活质量。
