Characteristics of disability in stroke patients (measured by the FIM)

我们调查了中风患者的一些特征，考虑了变量：住院时间、住院和出院时的功能独立性测量(FIM)评分、发病时间和FIM增益。我们计算每月的FIM效率。研究对象为164例住院脑卒中患者。他们的平均年龄为54.4岁。164例患者中脑梗塞68例，脑出血80例，蛛网膜下腔出血16例。73人左脑受损，91人右脑受损。自他们患中风以来，平均已经过去了114.5个月。平均住院天数为108.7天，入院时FIM评分为84·0±19·6，出院时为101.7±17·8。不同病种患者入院和出院时的FIM评分差异均无统计学意义。皮质下病变组高于皮质病变组。偏侧空间忽视患者和简易精神状态检查得分低于21分的患者的得分较低。住院时FIM评分低、FIM增益高的患者住院时间较长。FIM增加在住院早期通常较高，但即使在晚期也可以看到。我们发现，虽然住院时间不短，但即使是FIM评分较低的患者，通过适当的康复锻炼也能使FIM评分增加。有几名中风患者回到社区后FIM评分下降，尤其是出院时FIM运动评分在70分以上的患者。我们猜测，这种减少的原因之一是家人对患者的不必要帮助。对患者家属进行有关如何在家中照顾残疾人的教育对于社区康复的成功至关重要。

We investigated some characteristics of stroke patients, considered the variables : length of stay, Functional Independence Measure (FIM) score at hospitalization and discharge, length of time from the onset, and FIM gain. We calculated the FIM efficiency per month. The subjects were 164 inpatients with stroke. Their average age was 54.4 years. Of the 164 patients, 68 had had cerebral infarction, 80 had had cerebral hemorrhage and 16 had had subarachnoid hemorrhage. Seventy three had sustained damage in their left hemisphere, 91 in their right. An average of 114.5 months had passed since they had suffered from stroke. Their mean length of stay was 108.7 days.The average FIM score at hospitalization was 84.0±19.6 and that at discharge was 101.7±17.8. There was no significant difference in FIM score among different types of disease both at hospitalization and discharge. But it was higher in patients with subcortical lesion than those with cortical lesion. And it was lower in patients with hemispatial neglect or patients whose Mini Mental State Examination scores were lower than 21. The length of stay tended to be longer in patients whose FIM score at hospitalization was low and FIM gain was high. The FIM gain was usually high during the early stage of hospitalization, but it could be seen even in the late stage. We found that although the length of stay was not short, even the patients who had a low FIM score could make FIM gain with proper rehabilitation exercise.There were several stroke patients whose FIM score decreased after they went back to the community, especially those whose FIM motor score at discharge was in the seventies. We guessed that one of the reasons for this reduction was unnecessary help of the patients by the family. Education for the patient's family on how to care for disabled people in their home is important to the success of community based rehabilitation.