The Influence of Rehabilitation Therapy on the Prognosis for Stroke Patients－A Preliminary Study

腦中風患者復健治療預後之初步研究

林昭宏(Jau-Hong Lin) ； 蔚順華(Shun-Hwa Wei) ； 劉景寬(Ching-Kuan Liu) ； 黃茂雄(Mao-Hsiung Huang) ； 林永哲(Young-Tso Lin)

《The Kaohsiung Journal of Medical Sciences》 15卷5期 (1999/05) Pp. 280-291

https://doi.org/10.6452/KJMS.199905.0280

摘要

本研究目的以前瞻性方式初步探討住院復健科接受復健治療的腦中風患者社會人口學因素及住院期間臨床表現對於預後結果之相關性影響。本研究以高雄醫院附設中和醫院民國八十六年一月至十二月期間因腦中風住院，並且曾住在復健病房接受復健治療十天以上之患者147位為對象。收集中風患者社會人口學及住院期間臨床評估資料做為相關影響變項。出院時日常生活功能獨立自主量表(共分自我照顧、排便、移位、走動、溝通、社會認知等六大項，總分為126分)和住院期間量表進步量做為接受復治療預後結果的兩項指標。結果顯示影響出院時日常生活功能獨立自主量表得分的重要因素包括年齡、二次以上中風病史、住院期間多項併發症、感覺、定向能力異常及伴隨失智症等；而感覺異常和多次中風病史患者是影響住院期間功能獨立量表進步量的重要因素。本研究獲得以下結論：1)年齡是影響復健治療結果的重要因素；2)接受復健治療時間的延後並不一定會影響復健治療後獲得進步量的潛能；3)住院初期功能性量表得分較少的患者，預後結果雖然較差，但並未影響進步量的獲得；4)住院期間發生併發症會影響預後結果；5)神經心理徵動異常的患者不應該被排除接受復健治療。

並列摘要

The purpose of this prospevive study was to investigate the in fluence of rehabiliataion therapy on the prognosis for stroke patients. Sociodemographic and clinical factors were collected in a sample of 147 stroke patients (81 men and 66 women) admitted to inpatient rehabilitation department at our university hospital over 10 days between January 1, 1997 and December 31, 1997. Functional Independence Measure (FIM) scores at discharge and gains during rehabilitation preiod were used as the prognosis index. Statistical techniques with univariate and multiple regression analyses indicated that significant predictors of discharge FIM scores include age, previous attacks twice or over , medical comorbidities, sensory and orientation impariments, and dementia. In addition, previous stroke attacks twice or over and sensory impairment were significant predictors of FIM gains during rehabilitaiton period. We concluded that:1) age is a critical factor to determine the rehabitiation outcome, but may not be an important factor to predic the ability for the improvement through rehabilitaion therapy; 2) the delay of rehabilitation therapy may not affect the potential for further improvement; 3)patients with low initial functional level may have poor final outcome, they may still have good rehabilitation potential to improve the functional level; 4) complications of stroke may affect the rehabilitation outcome and should be prevented; and 5) patients with impaired mental status should not routinely be excluded from rehabilitation programs.

並列關鍵字

stroke ； prognosis ； rehabilitation therapy