The Case-control Study Of ICF Model As A Guide To Occupational Therapy In Stroke Patients

Objective:In order to improve the movement, cognitive and perceptual functions of stroke patients, it is more important to improve the quality of life in stroke patients, putting the patients back into the community,returning to the original life including work and study environment. In this study, stroke patients were monitored based on ICF occupational therapy and abilitation intervention effectiveness.Methods:Initially, 480 patients were selected before September 2015 in the Shanghai first people’s Hospital of rehabilitation centers( Le Du Hospital) in hospitalized stroke patients, by 1:1 matched layer to filter out 104 people in experimental group and the control group. All hospitalized stroke patients have used a framework of ICF to occupational therapy in the rehabilitation center since January 2014 the hospital applied for the accreditation of CARF. So the patients in the test group admission were in the hospital after January 2014 to September 2015, and the patients in the control group were in the hospital before December2013. Experimental group uses occupational therapy in the framework of the ICF rehabilitation interventions. Control group uses the traditional method of hand function of occupational therapy combined with physical therapy. Both of groups use one-to-one rehabilitation training, twice a day, 60 minutes each time, hospitalization period of 40 days. Before treatment, 2 weeks after treatment, 4 weeks after treatment using the“modified Barthel Index(MBI)” measurement tables, “Brunnstrom’s Recovery Stages of Stroke(BRSS)”, “ The ICF Generic Set assessment”to evaluate patients. Using SPSS20.0 statistical software for statistical analysis of all data, all significance levels were set at P<0.05.Result:1)The experimental group improved “modified Barthel Index(MBI)”scoring higher than the control group, 2 weeks after treatment(p<0.05),4 weeks after treatment(p<0.001), there was a significant difference between the two groups.The experimental group of “ the ICF Generic Set assessment” scores lower than the control group, 2 weeks after treatment(p<0.05), 4 weeks after treatment(p<0.001), there was a significant difference between the two groups. There were no significant differences between the two groups of “Brunnstrom’s Recovery Stages of Stroke(BRSS)” results(p>0.05).2) Patients with cerebral infarction: the experimental group improved “modified Barthel Index(MBI)” scoring higher than the control group,2 weeks after treatment(p<0.05), 4 weeks after treatment(p<0.001),there was a significant difference between the two groups. The experimental group of “ the ICF Generic Set assessment” scores lower than the control group, 2 weeks after treatment(p<0.05), 4 weeks after treatment(p<0.001), there was a significant difference between the two groups. “Brunnstrom’s Recovery Stages of Stroke(BRSS)” results show there were no significant differences between the groups(p>0.05).3) Patients with cerebral hemorrhage: the scores of“modified Barthel Index(MBI)”show there were no significant differences between two groups2 weeks after treatment(p>0.05). The experimental group improved“modified Barthel Index(MBI)” scoring higher than the control group,4 weeks after treatment(p<0.05), there was a significant difference between the two groups. According to “ the ICF Generic Set assessment”results, as shown in the scores, there were no significant differences between the two groups 2 weeks after treatment(p>0.05), there was a significant difference between the two groups 4 weeks after treatment(p<0.05). “Brunnstrom’s Recovery Stages of Stroke(BRSS)” results show there were no significant differences between the groups(p>0.05).Conclusion:According to the ICF of occupational therapy, stroke patients with the State of dysfunction have been improved. It is more important to consider patients in the various environments and backgrounds. In order to achieve real rehabilitation and improve the ability of daily life of stroke patients, quality of life, returning to the community for the stroke patients, returning to their original living and working environment, implementing ICF as a guide for stroke patients of occupational therapy is effective and is worthy of promotion.