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目的:从临床功能角度评估缺血性脑卒中社区康复临床路径康复方案的效果,为脑卒中社区康复临床路径的优化和推广提供数据支持。方法:采用随机、单盲、平行对照、多中心的前瞻性研究,符合纳入标准的缺血性脑卒中患者247例,随机分为临床路径组(129例)和常规康复组(118例)。临床路径组进入社区康复临床路径并执行相应康复治疗方案,常规康复组采取常规康复治疗,不进入临床路径,对康复治疗内容及时间不做要求。主要结局指标采用改良Barthel指数(MBI)及次要结局指标Fugl-Meyer运动功能评分量表(FMA)对两组患者ADL能力、综合功能水平、运动功能进行评定和分析。结果:临床路径组康复治疗前后的MBI差值、MBI改善程度均显著高于常规康复组,差异有显著性意义(P<0.05)。两组患者康复治疗前后FMA差值及FMA改善程度比较,差异有显著性意义(P<0.05)。结论:社区康复临床路径结合规范化的康复方案能提高缺血性脑卒中患者的ADL能力,改善患者的功能。
Objective: To evaluate the effect of clinical rehabilitation programs on community-based rehabilitation of ischemic stroke from a clinical perspective and to provide data support for the optimization and promotion of clinical pathways in community-based rehabilitation of stroke. Methods: A randomized, single-blind, parallel-controlled, multicenter prospective study of 247 patients with ischemic stroke that met the inclusion criteria was randomly divided into a clinical pathway group (129 patients) and a conventional rehabilitation group (118 patients). Clinical pathway group into the clinical path of community rehabilitation and the implementation of the corresponding rehabilitation programs, routine rehabilitation group to take conventional rehabilitation treatment, do not enter the clinical pathway, rehabilitation of the content and time do not require. MAIN OUTCOME MEASURES ADL ability, comprehensive functional level, and motor function were assessed and analyzed using the modified Barthel Index (MBI) and the secondary outcome measure, the Fugl-Meyer Motor Function Rating Scale (FMA). Results: The difference of MBI and MBI in rehabilitation group before and after rehabilitation were significantly higher than those in routine rehabilitation group (P <0.05). The differences of FMA and FMA between the two groups before and after rehabilitation were statistically significant (P <0.05). Conclusion: The clinical pathway of community rehabilitation combined with standardized rehabilitation programs can improve the ADL ability of patients with ischemic stroke and improve their function.