社区脑卒中患者家庭康复模式的疗效

目的:探讨社区脑卒中患者家庭康复的效果。方法:59例脑卒中患者随机分为社区组30例和对照组29例。2组均开设家庭病床并在家中接受医务人员诊治。社区组增加神经发育、运动再学习和针刺疗法等康复治疗。分别于治疗前、治疗1、2个月后及治疗结束后3个月采用综合痉挛量表(CSS)、Fugl-Meyer运动功能评定量表(FMA)、运动评定量表(MAS)、Berg平衡量表(BBS)、脑卒中患者姿势评定量表(PASS)、Holden步行功能评定表(FAC)和改良Barthel指数(BI)评定2组患者临床疗效。结果:治疗1、2个月后及治疗结束后3个月随访,2组FMA、MAS、BBS、PASS、FAC及BI评分均较治疗前明显提高(P<0.05),且社区组提高更显著(P<0.05);CSS评分社区组较治疗前及对照组有明显下降(P<0.05),对照组治疗前后差异无统计学意义。结论:脑卒中恢复期患者在社区开设家庭病床进行康复治疗能有效改善患者偏瘫肢体的运动功能,恢复日常生活活动能力提高患者生活质量。

Efficacy of Home-based Rehabilifation Model for Community Stroke Patients

Objective： To investigate the effect of home-based rehabilitation of community stroke patients.Methods： In a randomized controlled study,59 subjects were randomly assigned to two groups（community-rehab group and control group）.The basic domiciliary medical treatment for both groups was medicine.Medical doctors conducted home visit to subjects.Community-rehab group received extra domiciliary rehabilitation treatment including acupuncture,motor relearning program and neurodevelopment treatment for two months.Control group received simple rehabilitation exercise assisted by family members or nursing service.Measurements included Composite Spasticity Scale（CSS）,Fugl-Meyer Motor Assessment（FMA）,Motor Assessment Scale（MAS）,Berg Balance Scale（BBS）,Postural Assessment Scale for Stroke Patients（PASS）,Functional Ambulation Classification（FAC） and Modified Barthel Index（MBI）,and conducted before treatment,at the end of 1 month,at the end of 2 months and 3 months after treatment.Results：After treatment,both groups showed significant improved in FMA、MAS、BBS、PASS、FAC and MBI scores than before treatment（P〈0.05）,and the scores in the community-rehab group were much higher（P〈0.05）.CSS scores in the community-rehab group after treatmen were significant decreased than in the control group and before treatment（P〈0.05）.The difference of CSS scores in the control group had no statistical significance before and after treatment.Conclusion：The stroke patients recovering from home-based rehabilition model in the community can effectively improve the hemiplegic limb motor function,restore activities of daily liviing and improve the quality of life.