極早期活動是否能改善腦中風病人日常生活功能？

背景：衛生福利部近10年來統計資料顯示，腦血管疾病是國人十大死因（衛生福利部，2022），腦中風後的後遺症是導致成年人失能的主因，不僅造成病人及照顧者沈重的負擔，也影響生活品質。臨床上常有家屬心急地向醫療團隊提出何時可以開始執行復建，因此引發筆者想藉由實證探討「極早期活動是否能改善腦中風病人日常生活功能」，期將結果應用於臨床，以促進腦中風病人之日常生活功能，早日回歸社會。目的：藉由實證探討極早期活動是否能改善腦中風病人日常生活功能。方法：以PICO擬定關鍵字，搜尋中英文電子資料庫，符合納入條件之研究，使用CASP評析工具進行文獻資料評價及精粹。結果與結論：經由文獻篩選後共納入2篇系統性文獻回顧與統合分析文獻進行評讀，發現VEM皆定義為腦中風後2天（48小時）內開始予離床活動，其中離床活動包括坐、站、步行如廁等活動，結果皆顯示VEM可改善日常生活功能。期藉由實證結果應用於臨床，在中風後的黃金期陪伴病人在安全的狀態下早期活動及復健，並鼓勵家屬參與計畫，以協助及促進身體功能之恢復，達到早日重返社區之目的。

關鍵字

極早期活動；腦中風；日常生活功能

並列摘要

Background: Statistics from the Ministry of Health and Welfare in the past 10 years show that cerebrovascular diseases are the top ten causes of death in Taiwan (Ministry of Health and Welfare, 2022). Disability is a major sequelae of stroke in adults, which not only burden on patients and caregivers, but also affects the quality of life. Clinically, family members often ask when the rehabilitation can be started? Therefore, the author wants to explore whether Very Early Mobilization can improve activity of daily living of stroke patients, and hope to apply the research results to the clinic to promote the daily life function of stroke patients and return to society as soon as possible. Purpose: To explore whether Very Early Mobilization can improve Activity of daily living of stroke patients by evidence-based medicine methods. Methods: PICO was used to formulate keywords, and the Chinese and English electronic databases were searched, and CASP checklist was used to evaluate and summarize the literature. Results and Conclusion: A total of 2 systematic reviews and meta-analyses of literature were collected through literature screening for evaluation. It was found that VEM was defined as getting out of-bed within 2 days (48 hours) after stroke, and getting out of-bed included activities such as sitting, standing and walking to the toilet. The results showed that VEM could improve daily life functions. It is expect that the empirical results will be applied to clinical practice, the golden period after a stroke accompanies the patient in early activities and rehabilitation in a safe state, and encourages family members to participate in the plan to assist and promote the recovery of physical functions, so as to achieve the goal of returning to the community as soon as possible.

並列關鍵字

stroke ； very early mobilization ； activity of daily living

參考文獻

陳虹如、鄧玉婷、張郁琳、郭宜宸、林幼麗(2018)．提升腦中風病人首次下床之改善專案．護理雜誌，65(2)，85-92。

顏于芬、林美惠（2022）．照顧一位腦中風個案之護理經驗．長庚護理，33(1)，93-103。

嚴筱晴、潘冠碩、李旻昊(2020)．急性出血型腦中風的早期復健和早期活動．台灣中風醫誌，2(3)，230 – 237。

Ding, R., & Zhang, H. (2021). Efficacy of very early mobilization in patients with acute stroke: a systematic review and meta- analysis. Annals of palliative medicine, 10(11), 11776–11784.

Langhorne, P., Collier, J. M., Bate, P. J., Thuy, M. N., & Bernhardt, J. (2018). Very early versus delayed mobilisation after stroke. Cochrane database of systematic reviews, 10(10), CD006187.

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