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任彩丽,付娟娟,王红星,夏 楠,蔡德亮,伊文超,金 娟,刘守国,陈 伟,潘化平,苏 敏,项 洁,王德强,万春晓,冯 玲,沈光宇,吴传军,励建安.早期康复临床路径对缺血性脑卒中患者功能恢复影响的多中心、单盲、随机对照研究[J].中国康复医学杂志,2017,(3):275~282
早期康复临床路径对缺血性脑卒中患者功能恢复影响的多中心、单盲、随机对照研究    点此下载全文
任彩丽  付娟娟  王红星  夏 楠  蔡德亮  伊文超  金 娟  刘守国  陈 伟  潘化平  苏 敏  项 洁  王德强  万春晓  冯 玲  沈光宇  吴传军  励建安
南京医科大学附属无锡同仁(国际)
康复医院,214151
基金项目:江苏省临床医学科技专项项目(BL2012029)
DOI:
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摘要:
      摘要 目的:明确早期康复临床路径联合康复方案对缺血性脑卒中患者日常生活活动能力、运动功能的影响,为脑卒中早期康复临床路径的优化和推广提供数据支持。 方法:符合纳入标准的缺血性脑卒中患者286例,随机分为临床路径组(n=143)和常规康复组(n=143)。临床路径组入组后进入脑卒中早期康复临床路径及相应的康复治疗方案,常规康复组采取一般康复治疗,不进入临床路径,对康复治疗内容及时间不做要求。分别于入组前和临床路径介入后第三周末(即出院时)采用改良Barthel指数(modified Barthel index, MBI)和Fugl-Meyer运动功能评分量表(Fugl-Meyer motor assessment scale, FMA)评估两组患者的日常活动能力和运动功能。 结果:临床路径组康复治疗前后的MBI差值、MBI改善程度((MBI后-MBI前)/(100-MBI前)×100%)均显著高于常规康复组,差异有显著性意义(P<0.05)。两组患者康复治疗前后FMA差值及FMA改善程度[(FMA后-FMA前)/(100-FMA前)×100%]比较差异无显著性意义(P>0.05)。 结论:早期康复临床路径结合规范化的康复方案能提高缺血性脑卒中患者的日常活动能力的恢复。
关键词:临床路径  脑卒中  康复  日常生活活动能力
Effect of early rehabilitation clinical pathway on ischemic stroke patients: a randomized controlled trial    Download Fulltext
Wuxi Tongren International Rehabilitation Hospital, Wuxi, 214151
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Abstract:
      Abstract Objective: To investigate the effect of rehabilitation clinical pathway combined with rehabilitation program for patients with ischemic stroke and to provide theoretical basis for optimization and extension of early rehabilitation clinical pathway of stroke. Method: This is a randomized, sham-controlled, assessor blinded, multi-center prospective study. A total of 286 patients with ischemic stroke were randomized into the clinical pathway group and the conventional rehabilitation group. Patients in the clinical pathway group were treated according to specific rehabilitation clinical pathway, while the conventional rehabilitation group received usual rehabilitation program. The outcome measures included the modified Barthel Index (MBI) and the Fugl-Meyer motor assessment scale(FMA) were performed separately before and after clinical pathway intervention. Result:The difference of MBI and the improved scores of MBI in the clinical pathway group were higher than those in the conventional rehabilitation group (P<0.05), while no significant difference in FMA difference and FMA improved scores (P>0.05) were observed. Conclusion: Early rehabilitation clinical pathway, which combined with standardized rehabilitation program, can improve activities of daily living.
Keywords:clinical pathway  stroke  rehabilitation  activities of daily living
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