The Effect of Rehabilitation in a Comprehensive Inpatient Rehabilitation Unit on Mobility Outcome After Dysvascular Lower Extremity Amputation
The Effect of Rehabilitation in a Comprehensive Inpatient Rehabilitation Unit on Mobility Outcome After Dysvascular Lower Extremity Amputation
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DOI：
10.1016/j.apmr.2012.03.019
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发表时间：
2012-08-01
影响因子：
4.3
通讯作者：
Norvell, Daniel C.
中科院分区：
文献类型：
--
作者：
Czerniecki, Joseph M.;Turner, Aaron P.;Norvell, Daniel C.
目的：（1）比较截肢后12个月内曾去过综合住院康复中心（CIRU）与从未去过综合住院康复中心（CIRU）的患者的康复治疗总量;（2）确定截肢后第一年内的任何时间在CIRU中进行康复治疗是否与其他类型的康复护理环境相比，能带来更大的行动成功;以及（3）确定在CIRU治疗的那些患者，哪些特定的患者特征与改善的活动结果相关。设计：前瞻性队列研究。设置：两个退伍军人事务部医疗中心。参与者：在2005年9月至2008年12月期间，筛选了接受首次单侧大截肢术的外周血管疾病或糖尿病患者（N = 199）。其中，113例（57%）符合研究标准;其中，72例（64%）参与了研究。干预：在截肢后的前12个月内，曾经参加过CIRU与从未参加过CIRU。主要结果测量：康复治疗访视次数、运动能力指数评分和活动成功率。结果：在12个月期间，曾参加CIRU的患者的所有治疗访视的平均次数显著高于从未参加的患者（48.6 vs 22.6; P = 0.001）。每次康复治疗的平均总时间为0.83 +/-.27小时，从未参加的为0.60 +/-.20小时（P
Objectives: To (1) compare the total volume of rehabilitation therapy for patients ever attending a comprehensive inpatient rehabilitation unit (CIRU) versus never during the 12 months after amputation; (2) determine whether rehabilitation in a CIRU at any time in the first year after amputation results in greater mobility success compared with other types of rehabilitation environments of care; and (3) determine for those patients treated in a CIRU, which specific patient characteristics were associated with improved mobility outcome.Design: Prospective cohort study.Setting: Two Veterans Affairs medical centers.Participants: Patients (N = 199) with peripheral vascular disease or diabetes undergoing a first unilateral major amputation were screened for participation between September 2005 and December 2008. Among these, 113 (57%) met study criteria; of these, 72 (64%) participated.Intervention: Ever attending a CIRU versus never attending a CIRU in first 12 months after amputation.Main Outcome Measures: Number of rehabilitation therapy visits, Locomotor Capability Index scores, and mobility success.Results: The mean number of all therapy visits for patients ever attending a CIRU was significantly greater than that for those never attending over a 12-month period (48.6 vs 22.6; P = .001). Mean total time per any rehabilitation visit was .83 +/-.27 hours for those ever attending and .60 +/-.20 hours for those never attending (P