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目的观察脑卒中患者社区康复治疗对患者运动功能和日常生活活动(ADL)能力的恢复效果,探讨脑卒中患者社区康复的必要性。方法随机抽取86例脑卒中病程不超过6个月的患者分为康复组48例和对照组38例。康复组建立家庭病床进行康复治疗,对照组进行定期随访。两组分别于入组1、3、6、12个月采用时采用简化Fugl-eyer运动功能量表(FMA)评定肢体运动功能,改良Barthel指数(MBI)、功能综合评定量表(FCA)评定ADL能力,总体满意感量表(SWLS)评定生存质量。结果两组患者入选时简化FMA量表、MBI、FCA、SWLS量表评分无显著性差异。康复组在治疗第1个月时、FCA量表、MBI评分明显改善(P<0.01),简化FMA量表评分有较明显改善(P>0.05);对照组FMA量表评分、MBI、FCA量表评分也有改善,但幅度较康复组小。至3个月时,康复组FCA量表、MBI评分提高幅度减缓,简化FMA量表评定改善程度较前减少(P>0.05);对照组患者入组前后简化FMA量表评定无改善(P>0.05),MBI、FCA量表评分有轻微改善。至6、12个月时,康复组化FMA量表评定无改善(P>0.05),MBI、FCA量表评分有轻微改善。对照组FMA、MBI、FCA量表评分随病程延长,有退化趋势。SWLS方面,两组患者在1、3个月时SWLS均有提高,但至6、12个月时,康复组SWLS提高幅度减小;对照组患者无提高。结论脑卒中患者早期持续的开展社区康复治疗十分必要。经过社区康复治疗可改善多数患者的运动能力和日常生活活动能力,提高患者的生活满意度。
Objective To observe the effect of community rehabilitation on the motor function and activities of daily living (ADL) in stroke patients and explore the necessity of community rehabilitation in patients with stroke. Methods A total of 86 patients with stroke duration less than 6 months were randomly divided into rehabilitation group (48 cases) and control group (38 cases). The rehabilitation group established a family-friendly bed for rehabilitation and the control group conducted regular follow-up. The two groups were assessed by the Simplified Fugl-eyer Motor Function Scale (FMA) at the 1st, 3rd, 6th, and 12th months after admission for assessment of limb motor function, modified Barthel Index (MBI) and functional comprehensive assessment scale (FCA) ADL ability, the overall satisfaction scale (SWLS) to assess the quality of life. Results The two groups of patients were simplified FMA scale, MBI, FCA, SWLS scale score no significant difference. At the first month after treatment, the scores of FCA and MBI in the rehabilitation group were significantly improved (P <0.01), while those in the simplified FMA scale were significantly improved (P> 0.05). In the control group, the scores of FMA, MBI and FCA Table scores also improved, but less in magnitude than in the rehabilitation group. At 3 months, the improvement of FCA scale and MBI score of rehabilitation group was slowed down, and the improvement of simplified FMA scale was less than before (P> 0.05). There was no significant difference between the control group and simplified FMA scale (P> 0.05), MBI, FCA scale score slightly improved. At 6 and 12 months, there was no improvement in the FMA scale of rehabilitation group (P> 0.05), and MBI and FCA scales improved slightly. The scores of FMA, MBI and FCA in the control group decreased with the prolongation of disease duration. In SWLS, SWLS increased at 1 and 3 months in both groups, but SWI increased at 6 and 12 months in rehabilitation group and no increase in control group. Conclusion It is necessary for stroke patients to carry out community-based rehabilitation in the early stage. After community rehabilitation treatment can improve the majority of patients exercise capacity and daily living activities, improve patient satisfaction with life.