脑卒中患者出院时的功能结局预测

背景：通过入院时资料早期预测其出院时的功能结局对于了解预后、计划出院后的转归很有意义，目前关于脑卒中患者平衡功能的研究越来越受到重视，而国内缺乏关于平衡功能与出院时的功能结局的关系报道。目的：根据收集的资料预测脑卒中患者出院时的功能结局，以及它与Fugl-Meyer平衡得分、Be唱平衡量表得分的相关性。设计：以患者为研究对象，多因素、多变量研究。单位：一所大学医院的康复科。对象：2002—08／2003—05同济医院康复科和神经科住院的符合入选标准的首次脑卒中患者40例。方法：将收集的脑卒中患者资料与出院时的功能结局进行单因素和多因素分析，收集的资料包括患者的病史、体格检查、入院时Fugl-Meyer平衡量表评分、Berg平衡量表评分、日常生活活动能力及功能独立性评分，出院时评定功能独立性评分作为功能结局。主要观察指标：Berg平衡量表，Fugl-Meyer平衡量表与功能独立性评定的简单相关性分析，出院时功能独立性评分影响因子的逐步回归分析。结果：简单线性相关分析提示Berg平衡量表，Fugl-Meyer平衡量表得分与入院、出院功能独立性评定得分有较强的相关性(P&;lt;0．001或P&;lt;0．05)，逐步回归分析发现入院时功能独立性评定，日常生活活动能力评分，Berg平衡量表评分可以预测脑卒中患者出院时的功能结局。结论：出院时功能结局的预测因子为人院时功能独立性评定，日常生活活动能力评分，Berg平衡量表评分，它与Berg平衡量表有较强的相关性。     

脑卒中患者出院时功能结局的预测研究

目的根据患者人院时的各项资料预测脑卒中患者出院时的功能结局以及它与Fugl-Meyer平衡(FMB)得分、Berg平衡量表(Berg Balance Scale，BBS)得分的相关性。方法收集的资料包括患者的病史、体格检查、入院时FMB评分、BBS评分、日常生活活动能力(ADL)及功能独立性评定(Functional Indepen-dence Measure，FIM)得分，出院时评定FIM作为功能结局，资料采用简单线性相关分析、逐步回归分析。结果简单线性相关分析提示BBS、FMB得分与人院、出院FIM得分有较强的相关性，逐步回归分析发现人院时FIM、ADL、BBS评分可以预测脑卒中患者出院时的功能结局。结论人院时功能状态如FIM、ADL、BBS评分可以预测脑卒中患者出院时的功能结局，并且出院时的功能结局与患者人院时的BBS有较强的相关性。     

脑卒中患者急性期姿势控制能力对其功能结局的预测价值

目的:评定脑卒中急性期患者的姿势控制能力,可明确其存在问题,探讨脑卒中患者急性期的姿势控制能力与出院时日常生活活动能力的相关性。方法:选择2002-08/2004-08在中山大学附属第二医院康复医学科治疗的45例脑卒中急性期患者为观察对象。所有患者在发病1周内应用脑卒中患者姿势评定量表(12项,每项0～3分,总分36分)评定其姿势控制能力、简式Fugl-Meyer量表(共50项,总分100分,上肢66分,下肢34分)评定其运动功能,Berg平衡量表(14项,每项0～4分,总分56分)评定其平衡能力,Barthel指数(10项,总分100分)评定其日常生活活动能力,在出院时再次评定Barthel指数,所有量表评分越高,患者功能状态越好。应用Pearson检验分析脑卒中患者急性期的各量表得分和年龄等变量与出院时Barthel指数的相关性;并以逐步回归分析上述变量与出院时日常生活活动能力的关联程度。结果:按意向处理分析,45例患者均进入结果分析。Pearson相关分析显示脑卒中患者急性期的脑卒中患者姿势评定量表、简式Fugl-Meyer量表、Berg平衡量表、Barthel指数等变量与出院时Barthel指数高度正相关(r=0.708,0.602,0.655,0.635,P<0.001),患者年龄与出院时Barthel指数中度负相关(r=-0.468,P<0.05)。逐步回归分析结果显示脑卒中患者姿势评定量表评分是出院时日常生活活动能力的显著预测因子(R2=0.563,P<0.001),仅脑卒中患者姿势评定量表单独就可解释出院时56%的日常生活活动能力,而4个量表和年龄等变量共同才可解释出院时69%的日常生活活动能力。结论:脑卒中患者急性期的姿势控制能力、偏瘫侧肢体的运动功能、平衡能力、日常生活活动能力和年龄与患者出院时日常生活活动能力密切相关,是患者出院时日常生活活动能力的预测因素,而姿势控制能力更是显著预测因子。     

脑卒中患者急性期姿势控制能力对其功能结局的预测价值

目的：评定脑卒中急性期患者的姿势控制能力，可明确其存在问题，探讨脑卒中患者急性期的姿势控制能力与出院时日常生活活动能力的相关性。方法：选择2002-08／2004-08在中山大学附属第二医院康复医学科治疗的45例脑卒中急性期患者为观察对象。所有患者在发病1周内应用脑卒中患者姿势评定量表（12项，每项0～3分，总分36分）评定其姿势控制能力、简式Fugl-Meyer量表（共50项，总分100分，上肢66分，下肢34分）评定其运动功能，Berg平衡量表（14项，每项0-4分，总分56分）评定其平衡能力，Barthel指数（10项，总分100分）评定其日常生活活动能力，在出院时再次评定Barthel指数，所有量表评分越高，患者功能状态越好。应用Pearson检验分析脑卒中患者急性期的各量表得分和年龄等变量与出院时Barthel指数的相关性；并以逐步回归分析上述变量与出院时日常生活活动能力的关联程度。结果：按意向处理分析，45例患者均进入结果分析。Pearson相关分析显示脑卒中患者急性期的脑卒中患者姿势评定量表、简式Fugl-Meyer量表、Berg平衡量表、Barthel指数等变量与出院时Barthel指数高度正相关（r=0．708，0．602，0．655，0．635，P〈0．001），患者年龄与出院时Barthel指数中度负相关（r=-0．468，P〈0．05）。逐步回归分析结果显示脑卒中患者姿势评定量表评分是出院时日常生活活动能力的显著预测因子（R^2=0．563，P〈0．001），仅脑卒中患者姿势评定量表单独就可解释出院时56％的日常生活活动能力，而4个量表和年龄等变量共同才可解释出院时69％的日常生活活动能力。结论：脑卒中患者急性期的姿势控制能力、偏瘫侧肢体的运动功能、平衡能力、日常生活活动能力和年龄与患者出院时日常生活活动能力密切相关，是患者出院时日常生活活动能力的预测因素，而姿势控制能力更是显著预测因子。     

三种常用平衡量表评估脑卒中偏瘫患者平衡和功能结局的一致性

背景对脑卒中患者平衡评定有助于康复目标与治疗计划的制定.目的探讨脑卒中偏瘫患者常用的3个平衡量表各参数与其他功能评价变量之间的相互关系.设计平衡量表间变量参数.单位解放军总医院耳鼻咽喉科、康复医学科.对象2002-09/2003-07在解放军总医院康复医学科进行康复治疗的57例脑卒中偏瘫患者.均为首次发病、颈内动脉系统一侧大脑半球病变的患者,其中男45例,女12例,年龄14～79岁,病程0.3～11个月.方法对57例患者于康复训练后进行Berg平衡量表、改良Fugl-Meyer平衡量表、脑卒中患者姿势控制量表、下肢运动功能、日常生活活动能力和步行功能评定.用Pearson相关分析方法来确定3种平衡量表之间的相关性;确定3种平衡量表与下肢运动功能、日常生活活动能力和步行功能之间的相关性.主要观察指标①3种平衡量表之间的相关性.②3种平衡量表与下肢运动功能、日常生活活动能力之间的相关性.结果57例脑卒中偏瘫患者均进入结果分析.①Berg平衡量表评分(46.70±5.15),Fugl-Meyer平衡量表评分(10.26±1.58),脑卒中患者姿势控制量表评分(32 56±2.06),Fugl-Meyer评价法中下肢运动功能评分(22.35±5.82),功能独立性测量中的转移和行进项目评分(24.95±5.2),10 m最大步行速度为[(49.06±24.68)m/s].3种平衡量表之间呈高度相关(r=0.613～0.766,P＜0.001).②3种平衡量表与患者的下肢运动功能、日常生活活动能力和步行功能之间呈高度相关(r=0.479～0.718,P＜0.001).结论Berg平衡量表、Fugl-Meyer平衡量表和脑卒中患者姿势控制量表在评定脑卒中患者平衡功能方面具有良好的一致性和良好的效度,均可以反映脑卒中患者的平衡和功能结局,对患者下肢运动功能、日常生活活动能力及步行功能的恢复具有预测性.     

三种常用平衡量表评估脑卒中偏瘫患者平衡和功能结局的一致性：康复医学科

背景：对脑卒中患者平衡评定有助于康复目标与治疗计划的制定。目的：探讨脑卒中偏瘫患者常用的3个平衡量表各参数与其他功能评价变量之间的相互关系。设计：平衡量表间变量参数。单位：解放军总医院耳鼻咽喉科、康复医学科。对象：2002-09／2003-07在解放军总医院康复医学科进行康复治疗的57例脑卒中偏瘫患者。均为首次发病、颈内动脉系统一侧大脑半球病变的患者，其中男45例，女12例，年龄14-79岁，病程0．3～11个月。方法：对57例患者于康复训练后进行Berg平衡量表、改良Fugl-Meyer平衡量表、脑卒中患者姿势控制量表、下肢运动功能、日常生活活动能力和步行功能评定。用。Pearson相关分析方法来确定3种平衡量表之间的相关性；确定3种平衡量表与下肢运动功能、日常生活活动能力和步行功能之间的相关性。主要观察指标：①3种平衡量表之间的相关性。②3种平衡量表与下肢运动功能、日常生活活动能力之间的相关性。结果：57例脑卒中偏瘫患者均进入结果分析。①Berg平衡量表评分(46．70&;#177;5．15)，Fugl-Meyer平衡量表评分(10．26&;#177;1．58)，脑卒中患者姿势控制量表评分(32．56&;#177;2．06)，Fugl-Meyer评价法中下肢运动功能评分(22．35&;#177;5．82)，功能独立性测量中的转移和行进项目评分(24．95&;#177;5．2)，10m最大步行速度为[(49．06&;#177;24．68)m／s1。3种平衡量表之间呈高度相关(r=0．613-0．766，P&;lt;0．001)。②3种平衡量表与患者的下肢运动功能、日常生活活动能力和步行功能之间呈高度相关(r=0．479．0．718，P&;lt;0．001)。结论：Berg平衡量表、Fugl-Meyer平衡量表和脑卒中患者姿势控制量表在评定脑卒中患者平衡功能方面具有良好的一致性和良好的效度，均可以反映脑卒中患者的平衡和功能结局，对患者下肢运动功能、日常生活活动能力及步行功能的恢复具有预测性。     

偏瘫患者住院期间运动能力与日常生活能力的进展及其关系

目的:探讨脑卒中偏瘫患者通过正规康复训练后,其运动能力及日常生活能力有无进展、两者的进展是否有相关性及何种状态的运动能力及日常生活能力入院后能有较大程度的提高。方法:22例脑卒中后半年内的偏瘫患者,于2002-08/2003-06在南京医科大学第一附属医院康复科治疗。采用简易Fugl-Meyer运动功能评分方法评定患者运动能力,改良Barthel指数评定患者的日常生活能力。结果:22例患者入院时及出院时的Fugl-Meyer运动功能评分分别为(37.04±29.92)分及(45.82±28.42)分,入院及出院时的改良Barthel指数评分分别为(36.59±24.75)分及(59.32±25.04)分,治疗前后两者差异均存在非常显著性意义(P<0.01)。入院与出院Fugl-Meyer运动功能评分差值与改良Barthel指数差值之间的相关系数为0.17。入院及出院时Fugl-Meyer运动功能评分差值及改良Barthel指数评分差值与住院时间之间的相关系数分别为0.27,0.42。入院时Fugl-Meyer运动功能评分在80分以上者,出院时平均增加(2.00±0.63)分;在80分以下者,出院时平均增加(10.00±7.73)分。入院时改良Barthel指数在50分以上者,出院时增加(8.75±7.90)分;在50分以下者出院时增加(30.67±17.40)分。结论:康复训练可以提高患者的运动能力及日常生活能力,但两者的提高无明显相关性。入     

急性脑卒中患者入院康复时的平衡能力对出院结局的预测价值

目的:评估脑卒中患者的平衡功能,有助于确定患者脑卒中严重程度及判断预后,本研究目的为探讨脑卒中偏瘫患者入院康复时平衡能力与出院时日常生活活动能力相关性。方法:37例脑卒中偏瘫患者于入院康复时采用脑卒中患者姿势评定量表中的姿势维持和变换姿势项目来评价姿势维持和变换姿势能力,采用Berg平衡量表来评价患者的整体平衡能力,在出院时采用Barthel指数来评估ADL能力。所得资料先以Pearsonr检验入院时的姿势维持、变换姿势、整体平衡能力及年龄等变量与出院时ADL的相关性;以入院时的姿势维持、变换姿势、整体平衡能力和年龄作为独立变量,并以出院时ADL为因变量,以逐步回归分析检验上述变量与出院时ADL的关联程度。结果:入院时患者的姿势维持、变换姿势和整体平衡能力与出院时Barthel指数呈高度正相关(r=0.682—0.758,P<0.001),其中变换姿势能力是出院时的ADL能力的显著预测因子(R2=0.574,P<0.001)。结论:平衡能力的缺失对脑卒中患者功能预后有显著的影响,平衡训练是早期康复治疗中最迫切需求的治疗内容之一。     

脑卒中失语症患者日常生活能力康复的影响因素分析

目的 调查影响脑卒中失语症患者日常生活能力康复的因素,为临床早期康复和预防提供理论依据.方法 采取目的抽样方法,选取109例脑卒中失语症患者作为研究对象,在患者入院1周内采用一般资料调查表、家庭功能量表、美国国立研究所脑卒中量表、中国康复研究中心汉语标准失语症检查量表、非语言认知功能评估量表、半量化Berg平衡量表及Barthel指数评定量表进行调查;出院后3个月使用Barthel指数评定量表再次对患者进行日常生活能力评估,并分为良好组、不良组,分析其影响因素.结果 出院后3个月,脑卒中失语症患者日常生活能力康复良好73例、不良36例.Logistic回归分析结果显示年龄,吸烟史,病灶是否累及皮层,入院1周时的家庭功能、神经损伤严重程度、平衡能力对脑卒中失语症患者日常生活能力康复的预测作用具有统计学意义(P<0.05).结论 年龄、吸烟史、病灶是否累及皮层、家庭功能、神经损伤严重程度、平衡能力是脑卒中失语症患者日常生活能力康复的影响因素.     

偏瘫患者运动能力与日常生活能力的相关性

背景偏瘫患者日常生活能力的恢复一定程度上涉及到运动能力的恢复情况,但两者是不是有高度的相关性,既往的研究没有定论.目的探讨脑卒中偏瘫患者上、下肢运动能力与日常生活能力的相关性.设计病例分析.单位南京医科大学第一附属医院康复科.对象选择2002-08/2003-06在江苏省人民医院康复科住院的脑卒中偏瘫患者30例.男20例,女10例;年龄39～76岁.方法采用简易Fugl-Meyer运动功能评分方法评定患者运动能力,改良Barthel指数评定患者的日常生活能力.主要观察指标①脑卒中偏瘫患者运动功能评分和改良Barthel指数评分.②脑卒中偏瘫患者运动能力与日常生活能力的相关性.结果30例患者进入结果分析.①全身Fugl-Meyer运动功能评分平均为40.96±32.04,上肢运动功能评分平均为21.78±22.87,下肢运动功能评分平均为18.43±10.29.改良Barthel指数评分平均为39.46±25.94.②全身总Fugl-Meyer运动功能评分与改良Barthel指数评分的相关系数为0.65,其中上肢运动功能评分与改良Barthel指数评分的相关系数为0.62,下肢运动功能评分与改良Barthel指数评分的相关系数为0.61.结论偏瘫患者的运动能力与日常生活能力有一定的相关性,且上、下肢运动能力对日常生活能力的影响几乎相等.     

康复功能训练结合高压氧治疗改善早期脑卒中患者平衡功能

目的探讨康复功能训练结合高压氧对早期脑卒中患者平衡功能恢复的效果。方法40例脑卒中患者分为高压氧组和对照组,均常规治疗结合康复功能训练,高压氧组同时配合高压氧治疗。结果2组患者平衡功能评定(BBS)及功能独立性评定(FIM)得分治疗前后比较,均差异有显著性;治疗后2组间比较,高压氧组优于对照组(P<0.05)。结论康复功能训练结合高压氧治疗能显著改善脑卒中患者的平衡功能,提高治疗效果。     

Specificity of functional mobility measures in older adults after hip fracture: a pilot study

OBJECTIVE: To determine the relationships between measures of functional mobility (Timed Up and Go [TUG], Self-Paced Walking [SPW], Berg Balance Scale [BBS]) and global functional status (FIM trade mark instrument), the motor component of the FIM instrument (motor FIM), and the mobility/locomotor-specific FIM component (ML-FIM) in older patients admitted to an inpatient rehabilitation program after hip fracture. DESIGN: The TUG, SPW, BBS, and FIM instrument were administered within 24 hr after admission and before discharge to 20 patients undergoing inpatient rehabilitation after a hip fracture. RESULTS: Significant correlations at admission were found between FIM and TUG scores (r = -0.47; p < 0.05), TUG and motor FIM (r = -0.45; p < 0.05), TUG and ML-FIM (r = -0.58; p < 0.01), FIM and BBS (r = 0.60; p < 0.01), motor FIM and BBS (r = 0.50; p < 0.05), and ML-FIM and BBS (r = 0.45; p < 0.05). At discharge, a significant correlation was found between the motor FIM and SPW (r = -0.49; p < 0.05). Change scores between both the motor FIM and ML-FIM and TUG scores were significantly correlated (r = -0.47, p < 0.05, r = -0.50, p < 0.05, respectively). CONCLUSIONS: The FIM instrument, motor FIM, and ML-FIM may not be specific measures of functional mobility in patients with hip fracture.     

Clinical characteristics and rehabilitation outcomes of patients with posterior cerebral artery stroke

OBJECTIVES: To describe the demographics, clinical profile, and functional outcomes in posterior cerebral artery (PCA) stroke and to identify factors associated with functional change during rehabilitation and discharge disposition. DESIGN: Retrospective study of patients with PCA stroke admitted to a rehabilitation hospital over an 8-year period. SETTING: Free-standing urban rehabilitation hospital in the United States. PARTICIPANTS: Eighty-nine consecutive patients with PCA stroke (48 men, 41 women; mean age, 71.5y) met inclusion criteria. INTERVENTION: Inpatient multidisciplinary comprehensive rehabilitation program. MAIN OUTCOME MEASURES: Demographic, clinical, and discharge disposition information were collected. Functional status was measured using the FIM instrument, recorded at admission and discharge. The main outcome measures were the discharge total FIM score, the change in total FIM score (DeltaFIM), and the discharge disposition. Multiple and logistic regression analyses were performed to identify factors associated with the main outcome measures. RESULTS: The most common impairments were motor paresis (65%), followed by visual field defects (54%) and confusion or agitation (43%). The mean discharge total FIM score +/- standard deviation was 88.3+/-28.2. The mean DeltaFIM was 23.3+/-16.4. Fifty-five (62%) patients were discharged home. On multiple regression analysis, higher admission total FIM score, longer length of stay (LOS), and a rehabilitation stay free of interruptions were associated with higher discharge total FIM score and greater DeltaFIM. Absence of diabetes mellitus and younger age were also associated with higher discharge total FIM scores, and male sex had greater DeltaFIM. On logistic regression analysis, younger patients, higher discharge FIM scores, presence of a caregiver, and the nonnecessity for 24-hour support were associated with a discharge to home. CONCLUSIONS: Motor, visual, and cognitive impairments are common in PCA stroke, and good functional gains are achievable after comprehensive rehabilitation. Higher admission FIM scores, longer LOS, and younger and male patients were associated with better functional outcomes. Most patients were discharged home, particularly those with caregivers and those for whom 24-hour support was not required. Further research should aim at the development of functional outcome measures of greater breadth and sensitivity to visual and cognitive deficits and should compare PCA stroke outcomes with outcomes of strokes in other vascular territories.     

The Falls-Efficacy Scale,Swedish version: does it reflect clinically meaningful changes after stroke?

Purpose : The overall aim of this prospective investigation was to evaluate the ability of the Falls Efficacy Scale (Swedish version) (FES(S)) to reflect clinically meaningful changes over time. Method : Changes on the FES(S) scale were compared with changes in two different standardized measures of observer-assessed balance, the Berg Balance Scale (BBS), the Fugl-Meyer balance subscale (FMB), and of motor function and ambulation in 62 stroke patients. Assessments took place on admission for rehabilitation, at discharge and 10 months after the stroke. Indices of effect size were used to evaluate responsiveness of the instruments. Three time periods were studied: admission to discharge (early response), discharge to 10 month follow-up (late response) and admission to follow-up (overall response). Results : The main findings are that the FES(S) is as responsive as BBS and FMB in detecting changes during the early and overall response periods. Changes in FES(S) scores between admission and discharge correlated significantly with changes in observer-assessed balance, motor function and ambulation scores. Conclusions : The present results suggest that measurement of perceived confidence in task performance using the FES(S) scale is responsive to improvement in patients with hemiparesis at an early stage after stroke.     

FIM量表在外伤性颅脑损伤患者康复疗效评价中的应用

目的 :运用功能独立性评价量表 (FIM )评价外伤性颅脑损伤 (TBI)患者的康复治疗疗效 ,比较闭合性颅脑损伤 (CBI)和开放性颅脑损伤 (OBI)患者的临床特点和康复治疗的效果。方法 :79例TBI患者中 ,5 7例为CBI、2 2例为OBI。运用FIM量表评价两组患者康复治疗前后的功能情况 ,统计患者的入院天数 ,计算FIM效率。结果 :CBI和OBI患者入院时的FIM总评分分别为 81.5 1和 73.0 9;出院时FIM总评分分别为 115 .0 4和 117.77,两组平均增加 4 1%和 5 3%。两组患者康复治疗前后FIM各项评分自身相比有非常显著差异 (P <0 .0 0 1) ,但两组之间相比无显著差异。两组患者的FIM效率分别为 1.99分 /天和 1.71分 /天。结论 :康复治疗可有效改善TBI(无论是CBI还是OBI)患者的功能情况。康复治疗应强调早期和综合性治疗     

The Falls-Efficacy Scale,Swedish version: does it reflect clinically meaningful changes after stroke?

Purpose : The overall aim of this prospective investigation was to evaluate the ability of the Falls Efficacy Scale (Swedish version) (FES(S)) to reflect clinically meaningful changes over time.

Method : Changes on the FES(S) scale were compared with changes in two different standardized measures of observer-assessed balance, the Berg Balance Scale (BBS), the Fugl-Meyer balance subscale (FMB), and of motor function and ambulation in 62 stroke patients. Assessments took place on admission for rehabilitation, at discharge and 10 months after the stroke. Indices of effect size were used to evaluate responsiveness of the instruments. Three time periods were studied: admission to discharge (early response), discharge to 10 month follow-up (late response) and admission to follow-up (overall response).

Results : The main findings are that the FES(S) is as responsive as BBS and FMB in detecting changes during the early and overall response periods. Changes in FES(S) scores between admission and discharge correlated significantly with changes in observer-assessed balance, motor function and ambulation scores.

Conclusions : The present results suggest that measurement of perceived confidence in task performance using the FES(S) scale is responsive to improvement in patients with hemiparesis at an early stage after stroke.     

家属指导的髋外展肌群训练对偏瘫患者的影响

目的:探讨家属指导的髋外展肌群训练对偏瘫患者的影响。方法:50例卒中患者,随机分入家庭组和治疗师组各25例,2组患者均接受相同的常规康复治疗。在此基础上,家属指导家庭组患者进行髋外展肌群训练,治疗师指导治疗师组患者进行髋外展肌群训练。分别在治疗前和治疗6周后采用Berg平衡量表(BBS)、Fugl-Meyer下肢运动功能评定(FMA-LE)、徒手肌力检查(MMT)、Holden功能性步行量表(FAC)及功能独立性测量(FIM)中的"行走/轮椅"进行评定。结果:治疗6周后,2组的BBS、FMA-LE、MMT、FAC及FIM量表评定均较治疗前明显提高(P0.05),2组间比较均差异无统计学意义。结论:家属指导的髋外展肌群训练和治疗师指导的髋外展肌群训练均能明显改善脑卒中患者的平衡和步行能力,且2组效果无明显差异,提示髋外展肌群训练可加入家庭康复。     

Functional outcome of ischemic stroke: a comparative study of diabetic and non-diabetic patients

BACKGROUND AND PURPOSE: Diabetes is associated with more ischemic strokes and diabetic patients have up to a three-fold increased risk for suffering a stroke, compared with non-diabetics. The aim of this study is to evaluate whether diabetes mellitus may also affect the functional outcome of patients with acute ischemic stroke, undergoing post-acute care rehabilitation. METHODS: A retrospective charts analysis of consecutive older patients with acute ischemic stroke admitted for rehabilitation at a tertiary hospital with post-acute care geriatric rehabilitation wards. Functional outcome of diabetics and non-diabetics was assessed by the Functional Independence Measurement scale (FIM) at admission and discharge. Data were analysed by t-tests, Pearson correlation, and Chi-square test, as well as by linear regression analysis. RESULTS: A total number of 527 patients were admitted, of whom 39% were diabetics. Compared with non-diabetics, diabetic stroke patients were slightly younger (p = 0.0001) but had similar admission FIM scores. FIM gain parameters (total FIM gain, motor FIM gain, daily total and motor FIM gains) upon discharge were similar in both groups. A linear regression analysis showed that higher MMSE scores (beta = 0.08; p = 0.01) and higher admission total FIM scores (beta = 0.87; p < 0.001) predicted higher total FIM scores upon discharge. Diabetes mellitus was not interrelated, whatsoever, with better total FIM scores upon discharge (beta = -0.03; p = 0.27). CONCLUSIONS: The findings suggest that there is no difference in the functional outcome of diabetic and non-diabetic patients, presenting for rehabilitation after acute ischemic stroke. Diabetes should not be considered as adversely affecting rehabilitation of such patients.