不同服務密度居家物理治療對中風病人之療效

Effects of Home Health Physical Therapy Frequency on Functional Outcome of Stroke Patients

王瑞瑤(Ray-Yau Wang) ； 熊嘉玲(Chia-Ling Hsiung) ； 陳麗華(Lei-Hua Chen) ； 許君強(Chun-Chyang Hsu)

《物理治療》 28卷2期 (2003/04) Pp. 65-70

摘要

目的：本研究目的為探討不同服務密度居家物理治療對中風病人的療效。方法：中風個案經「台北市長期照護管理示範中心」轉介至台北市物理治療師公會接受居家物理治療服務，若其巴氏量表(Barthel Index)大於15分或巴氏量表中活動項目大於5分，且可了解簡單口令指示者則加入此研究計劃。參加之個案隨機分派至實驗組或對照組。實驗組（14人）接受一週2次居家物理治療，為期3個月，共計24次；對照組（16人）則接受一週l次居家物理治療，為期6個月，亦共計24次。兩組個案皆分別於治療前、24次治療結束後及之後3個月接受平衡及功能之評估。結果：實驗組與對照組的年齡及性別在統計學上並無差異。在經24次治療後，實驗組之巴氏量表分數呈明顯進步，且此進步可維持至治療結束後3個月。而對照組在治療24次後之巴氏量表分數則無明顯進步，但卻於治療結束後3個月呈現明顯進步。實驗組之下肢動作控制於治療結束後3個月呈現明顯進步。實驗組與對照組的平衡能力亦於治療結束後呈現明顯進步，且此進步可維持至三個月。結論：我們的結果顯示，每週2次為時三個月的居家物理治療可有效改善中風個案日常生活功能。建議全民健保以每週2次為時三個月（24次）之方式給付中風居家物理治療之服務，以提供中風個案持續之治療及照顧。

關鍵字

居家物理治療 ； 服務密度 ； 中風

並列摘要

Purposes: The purpose of this study was to investigate the effects of home health physical therapy frequency on fuctional outcome of stroke patients. Methods: Homebound stroke patients with Barthel index scored above 15 or with motion subscore of Barthel index greater than 5 were randomly assigned to either the experimental or the contrast group. 14 subjects in the experimental group received home health physical therapy twice a week for 3 months (24 visits), and 16 subjects in the contrast group received home health physical therapy once a week for 6 months (24 visits). Results: The mean age and gender of the two groups were not different. After 24 sessions of home health physical therapy, subjects in the experimental group demonstrated improvement in Barthel index score and such improvement was maintained at 3-month follow-up. Such improvement, however, was not observed in the contrast group after 24 visits. The ability of motor control of lower extremity was also improved in the experimental group Subjects in both groups demonstrated improvements in balance abilities measured by Berg balance scale after receiving 24 home health physical therapy treatments. Conclusions: The results of our study favor the home health physical therapy service provided at twice a week for a total of 24 times. We suggest that home health physical therapy program should be covered by the National Health Insurance to provide continuous services for homebound patients.

並列關鍵字

Home health physical therapy ； Service intensity ； Stroke revised