社区及家庭康复指导对脑卒中患者日常生活活动能力的影响

目的：探讨社区及家庭康复指导对脑卒中患者日常生活活动能力的影响。方法：276例脑卒中患者随机分为社区康复指导组141例和对照组135例，社区康复指导组进行康复治疗和随访，对照组只进行随访。在入组时、治疗后2个月和治疗后5个月分别用改良Barthel指数进行评定。结果：治疗后5个月的随访发现，康复指导组的日常生活活动能力明显好于对照组（P<0.01）。康复指导组的患者在入组时既往病例（发病3个月—1年半）的Barthel指数评分要好于新发病例（发病3个月内）（P<0.01）,到入组第2个月后及5个月后既往病例和新发病例的分数差距不大（P>0.05）,两组经5个月治疗后前后对比均有显著差异（P<0.01）。结论：社区康复指导对提高脑卒中患者的日常生活活动能力作用显著，对于既往病例，规范的社区康复指导对脑卒中患者的日常生活活动能力同样有着积极的作用。

Effect of community-and-family based rehabilitation guidance on ability of activity of daily living of stroke patients

Objective: To explore the effects of community-and-family based rehabilitation management on the activities of daily living (ADL) of stroke patients. Method: A total of 276 stroke patients were divided randomly into the community-based rehabilitation management group (treatment group, n=141) and the control group (n=135), The patients of the community -based rehabilitation management group were treated with rehabilitation and following-up, those of the control group were only by following-up. Both groups were evaluated with modified Barthel index before and 2, 5 months after treatment. Result: The ability of ADL in treatment group were more remarkable better than that in control group in the following-up after 5 months treatment (P＜0.01). In treatment group the Barthel index of the patients with a history of 3 to 18 months was significantly higher than that of 3 months (P＜0.01). The data showed that the effect of the disease time has no difference(P＞0.05) after 2, 5 months of treatment, whereas the mark of the treatment group was higher in each stage after 5 months of treatment (P＜0.01). Conclusion: Community-based rehabilitation management has significant effect on the ADL in stroke patients. The regular community-based rehabilitation management also has positive effect on the patients with a history of 3 to 18 months.