ORIJINAL ARAŞTIRMA
Subakut Nörolojik Rehabilitasyonda Gerçek Hayat Deneyimleri: Fonksiyonel Sonuçların Belirleyicileri
Real-Life Experiences in Subacute Neurological Rehabilitation: Predictors of Functional Outcomes
Received Date : 25 Jul 2023
Accepted Date : 17 Oct 2023
Available Online : 20 Oct 2023
Ayşe Merve ATAa, Ebru ALEMDAROĞLUa, Miray KARAMEHMETOĞLUa, Bedriye BAŞKANa, Refiye ÖNALa, Evren YAŞARa
aDepartment of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Therapy and Rehabilitation Hospital, Ankara, Türkiye
Doi: 10.31609/jpmrs.2023-98931 - Makale Dili: EN
J PMR Sci 2024;27(1):67-73.
ÖZET
Amaç: Bu çalışmanın amacı, subakut nörolojik rehabilitasyon ünitesinde
yatan hastaların klinik özelliklerini incelemek, hastalığın erken ve
geç döneminde rehabilitasyon programına katılan hastaları karşılaştırmak
ve rehabilitasyon sonucunu etkileyen bağımsız belirleyicileri tanımlamaktır.
Gereç ve Yöntemler: Retrospektif olarak tasarlanan çalışmada, subakut
nörolojik rehabilitasyon kliniğinde yatan tüm hastalar incelendi. İki yüz otuz
hastanın tıbbi kayıtları değerlendirildi. Olayın başlangıcından rehabilitasyon
ünitesine kabulüne kadar geçen süreye göre hastalar erken (≤1 ay) ve
geç (1-12 ay) olarak 2 gruba ayrıldı. Bulgular: Çalışmaya toplam 191 hasta
dâhil edildi. Başvuru anında geç grupta perkütan endoskopik gastrostomi
(p=0,001) ve trakeostomi (p=0,014) daha sıktı. Rehabilitasyon programından
tüm hastalar fayda görmesine rağmen Fonksiyonel Ambulasyon Sınıflandırması
(FAS) ve alt ekstremite Brunnstom Motor İyileşme Evresi
açısından faydalanım erken grupta daha yüksekti (sırasıyla p=0,030 ve
p=0,028). FAS iyileşmesi için erkek cinsiyet [göreceli olasılıklar oranı (odds
ratio “OR”)=1,85] ve erken rehabilitasyon grubunda olmak pozitif prediktörken
(OR=1,83), kontraktür varlığı (OR=0,28), basınç yarası (OR=0,37),
solunum sorunları (OR=0,23) ve uyku sorunları (OR=0,37) negatif belirleyiciler
olarak bulundu. Sonuç: Bu çalışmanın bulguları, nörolojik rehabilitasyonun
fonksiyonel sonuçlar için etkili olduğunu ve erkek cinsiyetin ve
erken rehabilitasyon grubuna katılımın artan ambulasyonun bağımsız belirleyicileri
olduğunu göstermektedir.
Anahtar Kelimeler: İnme; travmatik beyin yaralanması; omurilik yaralanması; rehabilitasyon
ABSTRACT
Objective: The aim of this study is to examine the clinical
features of patients hospitalized in the subacute neurological rehabilitation
unit, to compare the patients who participated in rehabilitation program in
the early and late period of the disease and to define the independent determinants
that affect the rehabilitation outcome. Material and Methods: In
a retrospective study, all patients in the subacute neurological rehabilitation
clinic were reviewed. The medical records of 230 patients were examined
retrospectively. Patients were categorized into two groups as early (≤1
month) and late (1-12 months) according to the time between the onset of
the event and admission to the rehabilitation unit. Results: A total of 191 patients
were included in the study. At the time of admission, percutaneous
endoscopic gastrostomy (p=0.001) and tracheostomy (p=0.014) were more
common in the late group. Although, all patients benefited from the rehabilitation
program, the benefit in terms of Functional Ambulation Classification
(FAC) and Brunnstom Motor Recovery Stage lower extremity was
higher in the early group (p=0.030 and p=0.028, respectively). The male
gender [odds ratio (OR)=1.85] and being in the early rehabilitation group
(OR=1.83) were positive predictors, the presence of contracture (OR=0.28),
pressure injury (OR=0.37), respiratory problems (OR=0.23), and sleep problems
(OR=0.37) were negative predictors for improvement of FAC. Conclusion:
The findings of this study indicate that neurological rehabilitation
is effective for functional outcomes and that male gender and participation
in the early rehabilitation group were independent predictors of increased
ambulation.
Keywords: Stroke; traumatic brain injury; spinal cord injury; rehabilitation
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