The Relation between Admission Balance and Functional Outcomes Following Stroke Rehabilitation: A Medical Center Based Study

腦中風患者住院時平衡能力和復健後功能的關係：一項醫學中心的研究

林昭宏(Jau-Hong Lin) ； 黃茂雄(Mao-Hsiung Huang) ； 劉景寬(Ching-Kuan Liu) ； 林永哲(Young-Tso Lin) ； 李建宏(Chien-Hung Lee)

《The Kaohsiung Journal of Medical Sciences》 15卷8期 (1999/08) Pp. 491-497

https://doi.org/10.6452/KJMS.199908.0491

摘要

本研究目的是以前瞻性方式探討住院復健科的腦中風患者臨床使用福格-米勒（Fugl-Meyer）平衡量表來評估住院時平衡能力和復健治療預後功能結果的相關性。本研究以高雄醫學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在復健病房接受復健治療之患者163位為對象。在剛住院復健和出院時，分別使用福格-米勒平衡能力和使用日常生活功能獨立自主量表（Functional Independence Measure）來評估日常生活功能狀況。並且依據接受復健治療住院天數長短和生活功能獨立自主量表待分進步情形和效率（Efficiency），做為評估以後功能結果的指標。先以皮爾森相關係數檢定平衡能力和預後功能結果的相關性。而後複迴歸統計分析結果顯示：當調整基本人口學因素後，評估住院初期平衡能力可以解釋接受復健治療住院天數6％的變異量及復健治療效率3％的變異量；然而，除了評估住院初期生活功能得分分數可以解釋接受復健治療期間生活功能得分進步情形4％的變異量外，平衡能力無法提供解釋生活功能得分進步情形的變異量。這些結果說明住院復健科初期臨床使用福格-米勒平衡量表來評估平衡能力似乎無法有效預測中風病患接受復健治療預後功能結果。

並列摘要

This prospective study evaluated the clinical use of the Fugl-Meyer Balance Scale (FMBS) on stroke patients during hospitalization and assessed the relationship between balance score at admission to the rehabilitation program and functional outcome at discharge. One hundred and sixty-three stroke patients admitted to the in –patient rehabilitation department of a university-based medical center between January 1 and December 31, 1997 were recruited for this investigation. Functional ability was evaluated with the Functional Independence Measure (FIMTM) instrument, and balance was measured using the 7-item Fugl-Meyer Balance Scale. These measures were assessed both at admission to and discharge from the inpatient rehabilitation program. Pearson correlation and multiple regression analyses were used to determine the relationship between balance and functional ability scores at admission and rehabilitation outcomes at discharge, including length of stay, functional gain, and efficiency. The results demonstrated that the balance score at admission accounted for 6% of the variation in length of stay, once demographic influences were controlled. The FIM efficiency score could possibly be predicted by the balance ability at admission, which accounted for 3% of the variance. However, the balance score could not provide predictive information about the FIM gain beyond that already provided by the FIM score at admission, which accounted for 4% of the variance with demographic factors controlled. Overall, balance ability at admission, assessed by the Fugl-Meyer Balance Scale, had no, or at least only little, contribution to account for the variance in rehabilitation outcomes. These findings suggest that the use of Fugl-Meyer Balance Scale at admission to stroke inpatient rehabilitation seemed not to enhance the ability to predict rehabilitation outcomes.

並列關鍵字

stroke ； balance ； rehabilitation outcome