The clinical and social factors associated with functional disturbance of acute hemiparetic stroke patients / 中华物理医学与康复杂志

ABSTRACT

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.