The impact of wheelchair propulsion based physical activity on functional recovery in stroke rehabilitation: a multicenter observational study
The impact of wheelchair propulsion based physical activity on functional recovery in stroke rehabilitation: a multicenter observational study
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基于轮椅推进的身体活动对中风康复功能恢复的影响：一项多中心观察研究
DOI：
10.1080/09638288.2020.1821249
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发表时间：
2020
影响因子：
2.2
通讯作者：
Yamada Minoru
中科院分区：
文献类型：
--
作者：
Kimura Yosuke;Ohji Shunsuke;Nishio Naohito;Abe Yuki;Ogawa Hideyuki;Taguchi Ryota;Otobe Yuhei;Yamada Minoru
目的我们旨在评估亚急性脑卒中幸存者每日轮椅自推进距离与功能恢复之间的关系。方法前瞻性招募来自四家康复康复医院的74名脑卒中患者。所有参与者均无法独立行走，入院时需要使用手动轮椅进行移动。使用连接到触摸开关的自行车计算机测量每日轮椅的自行推进距离，以排除辅助推进距离。结果测量表示为住院期间功能独立测量（FIM）有效性的相对增益。此外，更好的功能恢复被定义为 FIM 有效性 > 50%。根据轮椅每日平均自行推进距离的三分位，参与者被分为三组：最低三分位（T1，≤0.59公里/天）；中间三分位数（T2，0.60–1.23公里/天）；结果根据基线特征调整的多变量逻辑回归分析表明，T2 和 T3 组与更好的 FIM 有效性显着相关，其比值比（95% 置信区间，p）分别为 7.26（1.13–45.85，p= .038）和 10.19 (1.15–91.75,p= .035)。结论每日轮椅自走距离与亚急性中风幸存者的功能恢复显着相关。康复的意义非卧床中风幸存者在没有人协助行走时可以通过使用轮椅自走获得额外的独立身体活动。这项多中心观察性研究表明，手动轮椅与亚急性中风幸存者的功能恢复显着相关。
PurposeWe aimed to evaluate the relationship between the daily wheelchair self-propulsion distance and functional recovery in subacute stroke survivors.MethodsSeventy-four patients with stroke were prospectively recruited from four convalescent rehabilitation hospitals. All participants were unable to walk independently and required manual wheelchairs for locomotion on admission. The daily wheelchair self-propulsion distance was measured using a cycle computer that was connected to a touch switch to exclude the assistance-propulsion distance. The outcome measures were represented as the relative gain of the Functional Independence Measure (FIM) effectiveness during hospitalization. Moreover, a better functional recovery was defined as a FIM effectiveness > 50%. Participants were categorized into three groups according to tertiles of the average daily wheelchair self-propulsion distance: lowest tertile (T1, ≤0.59 km/day); middle tertile (T2, 0.60–1.23 km/day); and highest tertile (T3, ≥1.24 km/day).ResultsMultivariate logistic regression analysis adjusted for baseline characteristics showed that the T2 and T3 groups had a significant association with better FIM effectiveness, and their odds ratios (95% confidence interval, p) were 7.26 (1.13–45.85,p= .038), and 10.19 (1.15–91.75,p= .035), respectively.ConclusionsThe daily wheelchair self-propulsion distance was significantly associated with functional recovery in subacute stroke survivors.IMPLICATIONS FOR REHABILITATIONNon-ambulatory stroke survivors can obtain extra independent physical activity by using wheelchair self-propulsion, when they do not have someone to assist them with walking.This multicenter observational study revealed that the self-propulsion distance of a manual-wheelchair was significantly associated with functional recovery in subacute stroke survivors.