Bülau P, Fuger J, Horn H
Westerwaldklinik Waldbreitbach.
Nervenarzt. 1994 Dec;65(12):836-40.
Evaluation of therapeutic efficacy in neurologic rehabilitation is methodologically limited by the well established polypragmasia and the lack of untreated controls. Controversial discussion is generated by the following topics: superiority of specific therapy versus spontaneous recovery, higher efficacy of in-patient-setting versus out-patient-setting and the value of neurorehabilitation treatment in latency of more than 1 year after the event. To develop a practicable method for the evaluation of efficacy, we surveyed retrospectively 30 patients after stroke in a sequential study design on 4 scheduled visits: first admission to in-patient rehabilitation, discharge to out-patient treatment, admission and discharge of second in-patient rehabilitation. Impairment, disability and handicap were documented by NIH-Stroke Scale, Barthel-Index, CGI, WWK-Pflegeskala N and Risk-Profile. A descriptive data-analysis implies a therapeutic gain of stroke rehabilitation in-patient setting which is apparently superior to out-patient treatment. A measurable therapeutic effect was evident even more than one year after the stroke.
神经康复治疗效果的评估在方法上受到既定的多种治疗手段同时使用以及缺乏未治疗对照组的限制。以下主题引发了争议性的讨论：特定治疗相对于自发恢复的优越性、住院治疗与门诊治疗的更高疗效以及事件发生一年多后的潜伏期内神经康复治疗的价值。为了开发一种可行的疗效评估方法，我们采用序贯研究设计，对30例中风患者进行了回顾性调查，安排了4次预定访视：首次入住住院康复、出院至门诊治疗、第二次住院康复的入院和出院。通过美国国立卫生研究院卒中量表、巴氏指数、临床总体印象量表、WWK护理量表N和风险概况记录损伤、残疾和残障情况。描述性数据分析表明，中风康复住院治疗的疗效明显优于门诊治疗。即使在中风一年多后，也有明显可测的治疗效果。
