Abstract

Background/Objective

Previous research indicates a better improvement of functional independence measure (FIM) at discharge in acute-stroke patients who received physiatrist and registered therapist operating rehabilitation (PROr) within 24 hrs compared with those who received after 24 hrs was reported. The aim of this prospective cohort study was to determine whether PROr provided within 24 hrs for new-onset stroke patients affects home-discharge rate at 6 months later.

Methods

Acute new-onset stroke patients admitted to our hospital and received PROr (n = 227) and were conducted into 3 categories based on the time until starting PROr; within 24 hrs (very early mobilization; VEM; n = 47), 24-48 hrs (early mobilization; EM; n = 77) and >48 hrs (later mobilization; LM; n = 103). Home-discharge rates as well as changes in FIM, and rates of recurrence and mortality during the 6-month follow-up were assessed.

Results

A total of 139 patients [VEM (n = 32), EM (n = 43), LM (n = 64)] could be followed throughout the 6-month period. The home-discharge rate was ∼80% and significantly higher by ∼20% in VEM than EM. The gains in the motor subscale of FIM at 6 months were significantly higher in VEM than LM, while the mortality and recurrent rates were not significantly different among the categories.

Conclusions

Starting PROr within 24 hrs of new-onset stroke may help to increase home-discharge rates at 6-month follow-up, simultaneously with a higher FIM. Very early mobilization in our hospital did not increase the risks of recurrence or death.

中文翻译：

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新发卒中 24 小时内活动可提高 6 个月随访时出院率：一项前瞻性队列研究

摘要

背景/目标

先前的研究表明，与那些在 24 小时后接受治疗的急性卒中患者相比，在 24 小时内接受理疗师和注册治疗师手术康复 (PROr) 的急性卒中患者出院时的功能独立性测量 (FIM) 有更好的改善。这项前瞻性队列研究的目的是确定在 24 小时内为新发卒中患者提供的 PROr 是否会影响 6 个月后的出院率。

方法

我院收治接受PROr治疗的急性新发脑卒中患者（n  =227），根据直至开始PROr治疗的时间分为3类；24 小时内（非常早动员；VEM；n  = 47）、24-48 小时（早期动员；EM；n  = 77）和 >48 小时（后期动员；LM；n  = 103）。评估了 6 个月随访期间的出院率以及 FIM 的变化以及复发率和死亡率。

结果

在整个 6 个月期间，总共 可以跟踪139 名患者 [VEM ( n  = 32)、EM ( n  = 43)、LM ( n = 64)]。VEM的家庭放电率为~80%，比EM显着高~20%。6 个月时 FIM 运动分量表的增益在 VEM 中显着高于 LM，而死亡率和复发率在类别之间没有显着差异。

结论

在新发卒中 24 小时内开始 PROr 可能有助于提高 6 个月随访时的出院率，同时提高 FIM。我们医院的早期活动并没有增加复发或死亡的风险。