Inpatient rehabilitation following stroke: amount of therapy received and associations with functional recovery
Inpatient rehabilitation following stroke: amount of therapy received and associations with functional recovery
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DOI：
10.3109/09638288.2012.676145
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发表时间：
2012-01-01
影响因子：
2.2
通讯作者：
Teasell, Robert
中科院分区：
文献类型：
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作者：
Foley, Norine;McClure, J. Andrew;Teasell, Robert
目的：加拿大的中风护理最佳实践建议规定，每天至少为住院康复患者提供每种相关核心疗法一小时。我们检查了单个专门的卒中康复单元是否达到了这一标准，以及治疗量是否是功能改善的独立贡献者。方法：123名连续接受为期6个月的30张病床的中风康复计划的患者被纳入研究对象，这些患者被确诊为中风。工作量测量数据被用来估计患者在住院期间从核心治疗师那里接受的治疗量。使用与单变量分析中的函数增益显著相关的变量，还建立了预测功能独立性测量(FIM)增益的多变量模型。结果：患者平均每天接受物理治疗师(PT)和职业治疗师(OT)37分钟的积极治疗，接受言语语言病理学家13分钟的积极治疗。入院FIM、住院时间、总OT和PT治疗时间(HRS)与FIM增益显著相关。在最终的模型中，入院FIM评分和职业治疗总量(OT)是FIM收益的显著预测因子，该模型解释了35%的方差。结论：住进专门康复单元的患者平均每天接受职业治疗师和理疗师的治疗活动37分钟。虽然这一数值没有达到1小时的标准，但在住院期间，加班时间的总量对FIM积分的增加有显著贡献。
Purpose: Canada's Best Practice Recommendations for Stroke Care state that a minimum of one hour per day of each of the relevant core therapies be provided to patients admitted for inpatient rehabilitation. We examined whether this standard was met on a single, specialized stroke rehabilitation unit and if amount of therapy was an independent contributor to functional improvement. Methods: One-hundred and twenty-three, consecutive patients admitted to a 30-bed stroke rehabilitation program over a 6-month period with the confirmed diagnosis of stroke, were included. Workload measurement data were used to estimate the amount of therapy that patients received from core therapists during their inpatient stay. A multivariable model to predict Functional Independence Measure (FIM) gains achieved was also developed using variables that were significantly correlated with functional gain on univariate analysis. Results: On average, patients received 37 min of active therapy from both physiotherapists (PT) and occupational therapists (OT) and 13 min from speech-language pathologists per day. Admission FIM, length of stay, total OT and PT therapy time (hrs) were significantly correlated with FIM gain. In the final model, which explained 35% of the variance, admission FIM score and total amount of occupational therapy (OT) emerged as significant predictors of FIM gain. Conclusions: Patients admitted to a specialized rehabilitation unit received an average of 37 min a day engaged in therapeutic activities with both occupational and physical therapists. Although this value did not reach the standard of one hour, total amount of OT time contributed significantly to gains in FIM points during hospital stay.