影響腦中風患者功能進步量之因子－系統性回顧

Factors Influencing the Functional Improvement for Patients with Stroke-A Systematic Review

王雅嫻(Ya-Hsien Wang) ； 楊雅如(Yea-Ru Yang) ； 王瑞瑤(Ray-Yau Wang)

《物理治療》 32卷6期 (2007/12) Pp. 316-323

摘要

背景與目的：腦中風通常會導致患者生活及行動不便等長期的失能，若能早期預測腦中風患者的功能進步潛力，將有助於設立適當的目標和治療計畫。本系統性回顧希望在已發表的文獻中整理出腦中風患者功能進步量的重要影響因子。方法：由Medlin、Pubmed、中文電子期刊服務等資料庫中搜尋文獻。證據等級與推薦等級判定皆依據牛津實證醫學中心對預後型研究所建議的標準。結果：住院時功能獨立自主量表分數是影響功能進步量的重要因素。年齡、性別、中風部位、中風型態、有無合併症等因子並不影響功能進步量。結論：本篇系統性回顧獲得以下結論：(1)住院時功能獨立自主量表分數是影響功能進步量的重要因素。具有中等程度證據力，推薦等級「B」。(2)年齡並非影響功能進步量的重要因素。具有中等程度證據力，推薦等級「B」。(3)性別、中風部位、中風型態、有無合併症（如高血壓、糖尿病、心臟病）並不影響功能進步量。但證據力弱，推薦等級「C」。

關鍵字

腦中風 ； 預測 ； 功能進步

並列摘要

Background and Purpose: Prediction of functional improvement at early stage after stroke is critical because it enables therapist to set optimal treatment goals. The purpose of this systematic review was to investigate the influencing factors on functional improvement for patient with stroke. Methods: The literature was searched in the following three online electronic databases: PubMed, Medline, and Chinese Electronic Periodical Services. Both level of evidence and grade of recommendation were assessed according to Oxford Centre for Evidence-based Medicine Levels of Evidence. Results: The Functional Independence Measure (FIM) score at admission was a critical factor to predict the functional improvement during rehabilitation period. However, age, gender, location of stroke, type of stroke, and comorbidity were not the factors relating to functional improvement. Conclusions: The present systematic review showed the following results. First, FIM score at admission is a critical factor to predict the functional improvement during rehabilitation period, with recommendation grade B. Second, age may not affect the potential for functional improvement, with recommendation grade B. Third, functional improvement can not be predicted by gender, location of stroke, type of stroke, and comorbidity, with recommendation grade C.

並列關鍵字

Cerebrovascular accident ； Predict ； Functional improvement