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

中风患者的残疾特征（通过 FIM 测量）

• 批准号: 10838036
• 负责人: CHINO Naoichi
• 金额: $ 2.11万
• 依托单位: Keio University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10838036/
• 关键词: stroke; ADL; FIM; community based rehabilitation; 予後予測; 退院; 機能障害; リハビリテーション; 併存疾患; 機能的自立度評価; 能力低下; SIAS

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.

我们调查了脑卒中患者的一些特征，考虑了以下变量：住院时间、住院和出院时的功能独立性测量（Findability Measure，FAI）评分、从发病开始的时间长度和恢复增益。我们计算了每月的发电效率。研究对象为164例住院脑卒中患者。他们的平均年龄是54.4岁。在164名患者中，68名患有脑梗死，80名患有脑出血，16名患有蛛网膜下腔出血。73人的左半球受到损伤，91人的右半球受到损伤。他们患中风的平均时间为114.5个月。平均住院时间为108.7天，住院时平均ADL评分为84.0±19.6，出院时平均ADL评分为101.7±17.8。不同疾病类型患者入院时和出院时的COPD评分差异均无统计学意义。皮质下病变组高于皮质病变组。偏侧空间忽略或简易精神状态检查量表评分低于21分的患者其认知功能较低。住院时BMI评分低、BMI增加高的患者住院时间有延长的趋势。在住院的早期，肿瘤的生长通常是高的，但即使在住院的晚期也可以看到。我们发现，虽然住院时间不短，但即使脑卒中评分较低的患者，通过适当的康复锻炼，也可以获得康复，有几例脑卒中患者在返回社区后，脑卒中评分下降，尤其是出院时脑卒中运动评分在70多岁的患者。我们猜测，这种减少的原因之一是患者家属不必要的帮助。教育患者家属如何在家中照顾残疾人，对社区康复的成功至关重要。