Investigation on the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital_West China Medical Journal

Authors：

HUANG Neng ^1,2 , LIU Zuoyan ^1,2 ,  QU Yun ^1,3

1. Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University / West China School of Nursing, Chengdu, Sichuan 610041, P. R. China;
2. Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan 610041, P. R. China;
3. Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

QU Yun, Email: dr_yunqu@163.com

Keywords：

Stroke; rehabilitation; continued nursing; elderly; investigation

DOI：

10.7507/1002-0179.202004330

Video：

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Objective To investigate the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital. Methods Using the Barthel Index, the Modified Rivermead Mobility Index, the Zung Self-rating Depression Scale, and a self-designed rehabilitation exercise questionnaire, we conducted a cross-sectional investigation on the daily living ability, mobility, depression, and self-rehabilitation exercise of 207 stroke patients six months after discharge, who were discharged from the Rehabilitation Department of West China Hospital of Sichuan University between April 2017 and July 2019. The rehabilitation status of young and middle-aged (≥20 and <60 years old) stroke patients and elderly (≥60 years old) stroke patients were compared. Results There were 91 elderly patients and 116 young and middle-aged patients. Six months after discharge, the incidences of dysfunction in daily living ability (97.8% vs. 90.5%; χ²=4.598, P=0.032) and depression (51.2% vs. 36.2%; χ²=4.043, P=0.044) were higher in the elderly patients than those in the young and middle-aged patients, and the mobility score (26.38±9.77 vs. 29.47±10.60; t=2.154, P=0.032) and the proportion of patients taking self-rehabilitation exercise (93.4% vs. 100.0%; χ²=5.708, P=0.017) were lower in the elderly patients than those in the young and middle-aged patients. Conclusions In the process of continued rehabilitation nursing, different rehabilitation nursing measures should be implemented according to different ages, focusing on elderly stroke patients, and strengthening the supervision and promotion of rehabilitation training of daily living ability and mobility, psychological nursing and self-rehabilitation exercise compliance of elderly patients.

Citation： HUANG Neng, LIU Zuoyan, QU Yun. Investigation on the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital. West China Medical Journal, 2022, 37(1): 56-61. doi: 10.7507/1002-0179.202004330 Copy

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2.	Gropen T, Magdon-Ismail Z, Day D, et al. Regional implementation of the stroke systems of care model: recommendations of the Northeast Cerebrovascular Consortium. Stroke, 2009, 40(5): 1793-1802.
3.	Chan L, Wang H, Terdiman J, et al. Disparities in outpatient and home health service utilization following stroke: results of a 9-year cohort study in northern California. PM R, 2009, 1(11): 997-1003.
4.	Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci, 2004, 22(3/4/5): 281-299.
5.	Horgan NF, O’Regan M, Cunningham CJ, et al. Recovery after stroke: a 1-year profile. Disabil Rehabil, 2009, 31(10): 831-839.
6.	Gbiri CA, Akinpelu AO. Pattern of post-stroke functional recovery among Nigerian stroke survivors in the first 12 months. Nig Q J Hosp Med, 2011, 21(3): 245-248.
7.	全國腦血管病會議. 各類腦血管疾病診斷要點. 中華神經科雜志, 1996, 26(6): 379-381.
8.	Wade DT, Collin C. The Barthel ADL index: a standard measure of physical disability?. Int Disabil Stud, 1988, 10(2): 64-67.
9.	蔡業峰, 賈真, 李偉峰, 等. 中文版 Barthel 指數對多中心測評缺血性卒中患者預后的研究. 中國腦血管病雜志, 2007, 4(11): 486-490.
10.	Lennon S, Johnson L. The modified Rivermead Mobility Index: validity and reliability. Disabil Rehabil, 2000, 22(18): 833-839.
11.	Tsang RC, Chau RM, Cheuk TH, et al. The measurement properties of modified Rivermead mobility index and modified functional ambulation classification as outcome measures for Chinese stroke patients. Physiother Theory Pract, 2014, 30(5): 353-359.
12.	Zung WK. A self-rating depression scale. Arch Gen Psychiatry, 1965, 12(1): 63-70.
13.	王汝展, 劉蘭芬, 崔開艷, 等. ZUNG 氏抑郁自評量表作為內科住院患者抑郁障礙篩查工具的可行性研究. 中國健康心理學雜志, 2009, 17(8): 923-925.
14.	First MB, Spitzer RL, Gibbon M, et al. Structured clinical interview for DSM-Ⅳ axis Ⅰ disorders-patient edition. 2nd Ed. New York: Biometrics Research Department, New York State Psychiatric Institute, 1998: 1.
15.	全國人民代表大會. 中華人民共和國老年人權益保障法. (2019-01-07)[2020-02-01]. http://www.npc.gov.cn/npc/c30834/201901/47231a5b9cf94527a4a995bd5ae827f0.shtml.
16.	Rouillard S, De Weerdt W, De Wit L, et al. Functioning at 6 months post stroke following discharge from inpatient rehabilitation. S Afr Med J, 2012, 102(6): 545-548.
17.	Gbiri CA, Akinpleu AO, Ogunniyi A, et al. Clinical predictors of functional recovery at six month post-stroke. Asian J Med Sci, 2014, 6(1): 1642-1649.
18.	Rameezan BA, Zaliha O. Functional status of acute stroke patients in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Med J Malaysia, 2005, 60(5): 548-559.
19.	Hu MH, Hsu SS, Yip PK, et al. Early and intensive rehabilitation predicts good functional outcomes in patients admitted to the stroke intensive care unit. Disabil Rehabil, 2010, 32(15): 1251-1259.
20.	Fritz SL, Light KE, Clifford SN, et al. Descriptive characteristics as potential predictors of outcomes following constraint-induced movement therapy for people after stroke. Phys Ther, 2006, 86(6): 825-832.
21.	Kwah LK, Harvey LA, Diong J, et al. Models containing age and NIHSS predict recovery of ambulation and upper limb function six months after stroke: an observational study. J Physiother, 2013, 59(3): 189-197.
22.	姜嘟嘟, 柳毅剛, 宋浩明, 等. 腦卒中后抑郁的研宄進展. 神經病學與神經康復學雜志, 2018, 14: 172-177.
23.	Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2016, 47(6): e98-e169.
24.	De Wit L, Putman K, Baert I, et al. Anxiety and depression in the first six months after stroke. A longitudinal multicentre study. Disabil Rehabil, 2008, 30(24): 1858-1866.
25.	Hackett ML, Yapa C, Parag V, et al. Frequency of depression after stroke: a systematic review of observational studies. Stroke, 2005, 36(6): 1330-1340.
26.	Verdelho A, Hénon H, Lebert F, et al. Depressive symptoms after stroke and relationship with dementia: a three-year follow-up study. Neurology, 2004, 62(6): 905-911.
27.	Chau PC, Thompson DR, Chang AM, et al. Depression among Chinese stroke survivors six months after discharge from a rehabilitation hospital. J Clin Nurs, 2010, 19(21/22): 3042-3050.
28.	Chemerinski E, Robinson RG, Kosier JT. Improved recovery in activities of daily living associated with remission of poststroke depression. Stroke, 2001, 32(1): 113-117.
29.	Babkair LA. Risk factors for poststroke depression: an integrative review. J Neurosci Nurs, 2017, 49(2): 73-84.
30.	Frühwald S, L?ffler H, Eher R, et al. Relationship between depression, anxiety and quality of life: a study of stroke patients compared to chronic low back pain and myocardial ischemia patients. Psychopathology, 2001, 34(1): 50-56.
31.	Giaquinto S, Buzzelli S, Di Francesco L, et al. On the prognosis of outcome after stroke. Acta Neurol Scand, 1999, 100(3): 202-208.
32.	李佳祺, 趙彤, 楊琨, 等. 腦卒中病人日常感知歧視、失能程度與抑郁的相關性. 護理研究, 2021, 35(7): 1305-1307.
33.	Barker-Collo SL. Depression and anxiety 3 months post stroke: prevalence and correlates. Arch Clin Neuropsychol, 2007, 22(4): 519-531.
34.	張麗娟, 汝再華, 黃建華. 社區腦卒中患者功能鍛煉依從性影響因素分析. 中國鄉村醫藥, 2015, 22(2): 69-70.
35.	劉亞芳, 江華, 王秋華. 中青年腦卒中患者運動康復意愿及影響因素研究. 中國全科醫學, 2011, 14(4): 449-452.
36.	Lui KC, Hui SC. Participation in and adherence to physical activity in people with physical disability. Hong Kong Physiother J, 2009, 27(1): 30-38.
37.	Brown DR, Yore MM, Ham SA, et al. Physical activity among adults >or=50 yr with and without disabilities, BRFSS 2001. Med Sci Sports Exerc, 2005, 37(4): 620-629.

1. Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2014, 45(12): 3754-3832.
2. Gropen T, Magdon-Ismail Z, Day D, et al. Regional implementation of the stroke systems of care model: recommendations of the Northeast Cerebrovascular Consortium. Stroke, 2009, 40(5): 1793-1802.
3. Chan L, Wang H, Terdiman J, et al. Disparities in outpatient and home health service utilization following stroke: results of a 9-year cohort study in northern California. PM R, 2009, 1(11): 997-1003.
4. Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci, 2004, 22(3/4/5): 281-299.
5. Horgan NF, O’Regan M, Cunningham CJ, et al. Recovery after stroke: a 1-year profile. Disabil Rehabil, 2009, 31(10): 831-839.
6. Gbiri CA, Akinpelu AO. Pattern of post-stroke functional recovery among Nigerian stroke survivors in the first 12 months. Nig Q J Hosp Med, 2011, 21(3): 245-248.
7. 全國腦血管病會議. 各類腦血管疾病診斷要點. 中華神經科雜志, 1996, 26(6): 379-381.
8. Wade DT, Collin C. The Barthel ADL index: a standard measure of physical disability?. Int Disabil Stud, 1988, 10(2): 64-67.
9. 蔡業峰, 賈真, 李偉峰, 等. 中文版 Barthel 指數對多中心測評缺血性卒中患者預后的研究. 中國腦血管病雜志, 2007, 4(11): 486-490.
10. Lennon S, Johnson L. The modified Rivermead Mobility Index: validity and reliability. Disabil Rehabil, 2000, 22(18): 833-839.
11. Tsang RC, Chau RM, Cheuk TH, et al. The measurement properties of modified Rivermead mobility index and modified functional ambulation classification as outcome measures for Chinese stroke patients. Physiother Theory Pract, 2014, 30(5): 353-359.
12. Zung WK. A self-rating depression scale. Arch Gen Psychiatry, 1965, 12(1): 63-70.
13. 王汝展, 劉蘭芬, 崔開艷, 等. ZUNG 氏抑郁自評量表作為內科住院患者抑郁障礙篩查工具的可行性研究. 中國健康心理學雜志, 2009, 17(8): 923-925.
14. First MB, Spitzer RL, Gibbon M, et al. Structured clinical interview for DSM-Ⅳ axis Ⅰ disorders-patient edition. 2nd Ed. New York: Biometrics Research Department, New York State Psychiatric Institute, 1998: 1.
15. 全國人民代表大會. 中華人民共和國老年人權益保障法. (2019-01-07)[2020-02-01]. http://www.npc.gov.cn/npc/c30834/201901/47231a5b9cf94527a4a995bd5ae827f0.shtml.
16. Rouillard S, De Weerdt W, De Wit L, et al. Functioning at 6 months post stroke following discharge from inpatient rehabilitation. S Afr Med J, 2012, 102(6): 545-548.
17. Gbiri CA, Akinpleu AO, Ogunniyi A, et al. Clinical predictors of functional recovery at six month post-stroke. Asian J Med Sci, 2014, 6(1): 1642-1649.
18. Rameezan BA, Zaliha O. Functional status of acute stroke patients in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Med J Malaysia, 2005, 60(5): 548-559.
19. Hu MH, Hsu SS, Yip PK, et al. Early and intensive rehabilitation predicts good functional outcomes in patients admitted to the stroke intensive care unit. Disabil Rehabil, 2010, 32(15): 1251-1259.
20. Fritz SL, Light KE, Clifford SN, et al. Descriptive characteristics as potential predictors of outcomes following constraint-induced movement therapy for people after stroke. Phys Ther, 2006, 86(6): 825-832.
21. Kwah LK, Harvey LA, Diong J, et al. Models containing age and NIHSS predict recovery of ambulation and upper limb function six months after stroke: an observational study. J Physiother, 2013, 59(3): 189-197.
22. 姜嘟嘟, 柳毅剛, 宋浩明, 等. 腦卒中后抑郁的研宄進展. 神經病學與神經康復學雜志, 2018, 14: 172-177.
23. Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2016, 47(6): e98-e169.
24. De Wit L, Putman K, Baert I, et al. Anxiety and depression in the first six months after stroke. A longitudinal multicentre study. Disabil Rehabil, 2008, 30(24): 1858-1866.
25. Hackett ML, Yapa C, Parag V, et al. Frequency of depression after stroke: a systematic review of observational studies. Stroke, 2005, 36(6): 1330-1340.
26. Verdelho A, Hénon H, Lebert F, et al. Depressive symptoms after stroke and relationship with dementia: a three-year follow-up study. Neurology, 2004, 62(6): 905-911.
27. Chau PC, Thompson DR, Chang AM, et al. Depression among Chinese stroke survivors six months after discharge from a rehabilitation hospital. J Clin Nurs, 2010, 19(21/22): 3042-3050.
28. Chemerinski E, Robinson RG, Kosier JT. Improved recovery in activities of daily living associated with remission of poststroke depression. Stroke, 2001, 32(1): 113-117.
29. Babkair LA. Risk factors for poststroke depression: an integrative review. J Neurosci Nurs, 2017, 49(2): 73-84.
30. Frühwald S, L?ffler H, Eher R, et al. Relationship between depression, anxiety and quality of life: a study of stroke patients compared to chronic low back pain and myocardial ischemia patients. Psychopathology, 2001, 34(1): 50-56.
31. Giaquinto S, Buzzelli S, Di Francesco L, et al. On the prognosis of outcome after stroke. Acta Neurol Scand, 1999, 100(3): 202-208.
32. 李佳祺, 趙彤, 楊琨, 等. 腦卒中病人日常感知歧視、失能程度與抑郁的相關性. 護理研究, 2021, 35(7): 1305-1307.
33. Barker-Collo SL. Depression and anxiety 3 months post stroke: prevalence and correlates. Arch Clin Neuropsychol, 2007, 22(4): 519-531.
34. 張麗娟, 汝再華, 黃建華. 社區腦卒中患者功能鍛煉依從性影響因素分析. 中國鄉村醫藥, 2015, 22(2): 69-70.
35. 劉亞芳, 江華, 王秋華. 中青年腦卒中患者運動康復意愿及影響因素研究. 中國全科醫學, 2011, 14(4): 449-452.
36. Lui KC, Hui SC. Participation in and adherence to physical activity in people with physical disability. Hong Kong Physiother J, 2009, 27(1): 30-38.
37. Brown DR, Yore MM, Ham SA, et al. Physical activity among adults >or=50 yr with and without disabilities, BRFSS 2001. Med Sci Sports Exerc, 2005, 37(4): 620-629.

West China Medical Journal

Investigation on the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital

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