社区康复对脑卒中患者上肢功能及日常生活活动能力的远期疗效观察

Long-term effects of community-based rehabilitation on upper extremity function and activities of daily living in stroke patients

目的:探讨社区康复对脑卒中患者上肢功能及日常生活活动能力的远期疗效。方法:80例脑卒中患者随机分为社区康复组(40例)和对照组(40例),社区康复组进行康复治疗和随访,对照组只进行随访。于入组时、第5个月末和17个月末应用巴氏指数(BI)、临床神经功能缺损评分量表(NIM)中关于肩、臂运动及手运动的评定对两组患者进行评定。结果:入组时两组患者NIM和ADL评分比较,差异无显著性意义(P>0.05),第5个月和17个月后两组评分比较,差异有显著性意义(P<0.05),康复组效果优于对照组,而对照组第5个月末至第17个月末评分差异无显著性意义(P>0.05)。结论:社区康复对脑卒中患者上肢功能及ADL的恢复有远期作用;社区康复治疗介入时间越早脑卒中患者上肢功能和ADL恢复的作用越明显。

Objective： To explore long-term effects of community-based rehabilitation （CBR） on upper extremity function and activities of daily living （ADL） in stroke patients. Method： Eighty stroke patients were randomly divided into control group （n=40） and rehabilitation group （n=40）. The patients in rehabilitation group were treated with CBR and regular following-up, functional assessment, while the patients in control group only treated with following-up and functional assessment, no rehabilitation treatment. The Barthel Index（BI） and Clinical Neural Impairment Measures Scale （NIM） were applied to assess patients at the beginning of enrollment, and the end of the 5th and 17th month. Result： At the beginning of enrolhnent,the difference in scores of NIM and ADL between two groups was not obvious （P〉0.05）. There were significant differences in scores between two groups 5 and 17 months later （P〈0.05）. In rehabilitation group there was a better outcome than that in control group. In control group there was no significant difference in scores from the 5th month to the 17th nlonth （P〉0.05）. Conclusion： Communitybased rehabilitation can provide long-term effects on upper extremity function and ADL in stroke patients. The earlier the CBR received, the better the improvement on upper extremity function and ADL acquired.