影响脑卒中偏瘫患者日常生活能力恢复的因素分析

目的:分析脑卒中偏瘫患者治疗前后影响日常生活活动能力(activitiesofdailyliving,ADL)的相关因素。方法:对53例脑卒中偏瘫患者治疗前后进行上下肢功能、ADL等相关因素评定。结果:影响入院前ADL(ADL0)的正性因素包括肌张力、治疗前下肢运动能力,负性因素为年龄、尿便失禁、入院前居住地及发病次数。治疗后ADL(ADL1)的正性因素有ADL0和病变性质,而患肢腱反射的亢进或减弱和发病后住院时间则是ADL1预后的负性因素。家庭人数与ADL1恢复程度呈负相关(r=-0.527,n=53)。结论:肌张力和患肢腱反射是影响患者ADL恢复的有利因素;家庭人数多是ADL恢复的阻碍因素,提示对家属进行康复意识的教育非常必要。

Predictive analysis of activities of daily living in stroke patients with hemiplegia

AIM:To explore correlative factors with activities of daily living (ADL) before and after rehabilitation therapy and to prognosticate outcomes of ADL in stroke patients with hemiplegia.METHODS:Fifty three stroke patients with hemiplegia diagnosed by clinical examination and CT or MRI were given rehabilitation program. The assessments for stroke patients included mini mental state examination scores, upper limbs motor ability, motor ability in trunk and lower limbs, Barthel ADL index, and other independent variables over 20 items.RESULTS:The length of stay of stroke rehabilitation were averagely 2.4 months.The level of ADL in stroke patients increased significantly from 58.713.22 in admission to rehabilitation (ADL0)] to 74.863.02 in discharge from hospital (ADL1)].As shown by stepwise multiple regression analysis, positive predictors for ADL0 included muscle tonus,motor ability of trunk and lower limbs. Negative predictors for ADL0 contained age,incontinence, inhabitancy before rehabilitation program and onset numbers. The level of ADL0 and character of stroke were positive predictive variables for ADL1.Suffered tendon reflex and length of rehabilitation hospital stay were negative predictive variables for ADL1.Family numbers correlated negatively with the level of ADL1 (r=-0.527, n=53). CONCLUSION:Muscle tonus and suffered tendon reflex can reflect recovery processes in central nerve function. Proper length of rehabilitation hospital stay may be favorable to facilitate recovery of ADL in stroke patients. Family numbers might be a block factors for recovery of ADL, suggesting it is very important to educate consciousness of rehabilitation for family numbers with stroke patients.