Group intensive rehabilitation for lower limb functional recovery early after stroke : A non-randomized controlled trial

抄録

The purpose of this study was to examine whether group intensive rehabilitation (GIR) can significantly improve lower limb functional outcome in patients early after stroke compared to routine rehabilitation (RR). Ninty-four patients were enrolled in this study who received GIR, individual intensive rehabilitation (IIR) or RR. Lower limb motor function was assessed using the Fugl-Meyer Assessment of Motor Recovery (FM). Dependence was recorded using the Modified Barthel Index (MBI), which is an index of daily living activities (ADL). Measures were taken before treatment and 3 weeks later respectively. Socioeconomics significance was assessed using rehabilitation cost-effectiveness ratio (CER). GIR and IIR produced greater gains than RR both in lower limb FM (p<0.01, p<0.01, respectively) and MBI (p=0.007, p=0.026, respectively) at 3 weeks after intervention. There were no significant differences both in FM and MBI score changes of lower limb between GIR and IIR (p=0.365, p=0.782, respectively). GIR had lower CER than IIR and RR (p<0.01, p<0.01, respectively). There were significant differences in CER between the three groups. Subjects in GIR had lower CER compared with those in IIR and RR (p<0.01, p<0.01, respectively). Patients receiving GIR or IIR could make greater gains than those receiving RR in lower limb motor function and ADL early after stroke, while there were no differences between those receiving GIR and IIR, which indicated that this beneficial effect was attributed to higher intensity of therapy, but had nothing to do with group factors. GIR may be a pragmatic, effective and economical method for patients early after stroke allowing for the optimal utilization of resources.