The Study On Ischemic Stroke Patients Rehabilitation Outcome And Related Factors

ObjectiveThis rese arch is t o evaluate the ef fect of in-hospital rehabilitation of patients after ischemic stroke and the degree of patients’ participation; analyze factors that affect patients’ activities of daily life, F MA and d egree of p articipation; discussing the relationship between patients’ rehabilitation efficacy and parti cipation degree. The aim is to provide information and scientific basis for rehabilitation and to improve the level of patients’ participation.MethodChoosing 132 patients at t he Department of Reh abilitation who survived after ischemic stroke in 10,2013~7,2014 at a three level hospital in Kaifeng. The contents included① information on population statistics and disease data of the patients;② Modified Barthel Index(MBI) to evaluate patients’ activities of daily life;③simply FMA scale to evaluate the motor function;④Pittsburgh Rehabilitation Participation Scale(PRPS) to evaluate patients’ degree of participation;⑤Self-Rating Depression Scale(SDS) to evaluate whether the patient has depression and t he degree of depressi on;⑥Mini mental state examination(MMSE) to evaluate whether the patient has cognitive dysfunction.Using the software of EpiData 3.1 to establish the database and SPSS 19.0 to analyze the statistics. descriptive analysis, t test, one-way analysis of variance, rank test to express evaluation of rehabilitation effect, patient participation and the related influencing factors of single factor analysis; the correlate, Logistic regression were used to do multiple factors analysis. The level of the test was 0.05 and P values were two-tail probability.Results1. Motor function, activities of daily living at one month after rehabilitation and single factors analysisThe activities of daily living scores improved from(24.68±13.97)to(49.30±14.88),and motor function improved from(20.89±18.88)to(44.86±16.39).Old, depression may cause worse outcome(P﹤0.05), no cognitive dysfunction patients’ outcome were better than the cognitive dysfunction’s(P﹤0.05); the patients whose main caregivers is spouse, feel the patient-doctor relationship is good, high degree of participation get better outcome.2.Motor function, activities of da ily living at three month after rehabilitation and single factors analysisAt three month the activities of daily living scores came to(71.43±21.88),and motor function came to(70.02±20.03).Degree of participation, degree of education, individual income, marriage and medical insurance are good factors for patients rehabilitation outcome; the risk factors are old, rehabilitation intervention time, cognitive dysfunction, depression, the main caregiver is not spouse, feel patient-doctor relationship is not good.3.Multiple factor regression analysis of rehabilitation outcome at three monthMultiple factor regression analysis res ults show that the protect factors of motor function at three month are motor function at beginning, degree of participation with OR values 7.971、2.007,the risk factors of motor function at three month are cognitive and feeling of patient-doctor relationship with OR values 0.285、0.149. The protect fa ctors of a ctivities of daily living at three month are activities of daily living at beginning, degree of participation, OR values are 25.35 and 7.09, the risk factors of activ ities of dai ly living at three month are marital status, cognitive, feeling of patient-doctor relationship, the main caregiver with OR values 0.023,0.475,0.037,0.147.4.Degree of participation and single factors analysisThe score of patients’ participation was(4.30±1.16)points. Sex has no infl uence on pat ients’ participation, P>0.05. Age, degree of education,marital status, individual income, rehabilitation intervention time, location of h emiplegic paralysis, knowledge of rehabilitation, depression, cognitive, medical insurance, feeling of patient-doctor relationship, the main caregiver have influence on patients’ participation, P<0.05.5.Multiple factor regression analysis of participationMultiple fa ctor regression a nalysis resu lts showed that cognitive dysfunction and depression had influence on patients’ participation, and OR values were 0.012 and 0.018,yet the cognitive dysfunction and depression were risk factors for patients’ participation.6. The relationship between patients’ rehabilitation outcome and participationEvery time of the r ehabilitation outcome of ischemic patients and the degree of participation are positively re lated(P﹤0.05); the higher degree of participation,the better outcome of rehabilitation.Conclusions1.Continuous normal rehabilitation therapy is very important for ischemic stroke patients’ to achieve good rehabilitation outcome; factors affect motor function and activities of daily living rehabilitation outcome include start motor function, start activities of daily living, degree of rehabilitation participation, cognitive and patient-doctor relationship.2.Participate is a decisive role in patients rehabilitation outcome. Now the overall degree of patients’ participation is not very good. Cognitive dysfunction, depression have obvious influence on participation.