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

我们研究了脑卒中患者的一些特征，考虑了变量：住院时间、住院和出院时的功能独立测量（FIM）评分、发病时间和FIM增益。我们按月计算FIM的效率。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，脑梗死68例，脑出血80例，蛛网膜下腔出血16例。73人的左半球持续受损，91人的右半球受损。他们中风的平均时间为114.5个月。平均住院时间为108.7天。住院时平均FIM评分为84.0±19.6分，出院时平均FIM评分为101.7±17.8分。不同疾病类型在住院和出院时的FIM评分差异无统计学意义。但皮质下病变患者比皮质病变患者高。半脑忽视患者或迷你精神状态检查得分低于21分的患者的这一比例更低。住院时FIM评分低而FIM增益高的患者住院时间往往更长。FIM增益通常在住院早期较高，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，通过适当的康复运动也可以使FIM增加。有部分脑卒中患者在返回社区后FIM评分下降，尤其是出院时FIM运动评分在70左右的患者。我们猜测，这种减少的原因之一是家庭对患者的不必要帮助。教育病人家属如何在家中照顾残疾人士，对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.