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  

Balance ability at rehabilitative admission in stroke patients: Does it predict the rehabilitative outcome?

作　　者：瓮长水[1] 毕胜[1] 霍春暖[2] 高丽萍[3] 刘忠文[1] 杨娟[1] 秦茵[1] 于增志[1] 王军[1] 

机构地区：[1]解放军总医院康复医学科,北京复兴路28号100853 [2]解放军总医院神经内科 [3]解放军总医院中医科

出　　处：《中国康复医学杂志》2004年第5期343-345,共3页Chinese Journal of Rehabilitation Medicine

摘　　要：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。Objective: To assess the relationship between balance at rehabilitation admission and ADL function at discharge in stroke patients.Method:Thirty-seven stroke patients were tested for maintaining posture and changing posture (using the maintaining a posture and changing posture items of the postural assessment scale for stroke patients,PASS-MP and PASS-CP) and total balance (using the Berg balance scale) at admission and ADL function (using the Barthel index) in all patients at discharge were evaluated. The data were tested using Pearson′s correlation(r) to determine the relationships between ADL function at discharge and the following variables: age, admission PASS-MP score?admission PASS-CP score and total balance. Stepwise regression analysis was used to examine the relationship between these variables and ADL function at discharge.Result: PASS-MP score?PASS-CP score and BBS at rehabilitation admission were significantly positive related to ADL function at discharge in stroke patients(r=0.682-0.758,P<0.001). The PASS-TC score had slightly more power in predicting ADL function at discharge(R2=0.574,P<0.001).Conclusion:Impairments in balance appear to have a significant impact on functional outcome.The results imply that early assessment and management of changing posture after stroke should be emphasized.Author′s address Department of Rehabilitation Medicine,The General Hospital of PLA,Beijing,100853

关 键 词：脑卒中 康复治疗 平衡功能 日常活动 疗效 

分 类 号：R49[医药卫生—康复医学]