"General-Specialized"community rehabilitation model and prognosis of motor function in stroke
Objective:To explore the prognostic impact of the application of a"General-Specialized"combination community rehabilitation model on patients with initial stroke and residual motor dysfunction.Methods:A total of 100 patients with initial stroke and residual motor dysfunction who visited Xinhua Hospital Affiliated to Shanghai Jiao Tong University,from September 2021 to November 2022 were selected and divided into a community rehabili-tation group(50 cases)and a specialized rehabilitation group(50 cases).The specialized rehabilitation team conduc-ted stroke motor function rehabilitation intervention for 12 months at Shanghai Second Rehabilitation Hospital,col-lecting general information and motor function related scales including Activities of Daily Living(ADL),Fugl Meyer assessment scale(FMA),Berg Balance scale(BBS),and modified Rankin scale.After discharge,patients in the community rehabilitation group were referred downwards to various community rehabilitation centers(Songnan Community Rehabilitation Center in Baoshan District and Yinhang Community Rehabilitation Center in Yangpu Dis-trict)for a 12 month"General-Specialized"community rehabilitation intervention.The aforementioned scales,relat-ed prognosis,knowledge,attitude,and practice(KAP)scores within and between the two groups after 12 months of intervention were analyzed and compared.Results:The patients who completed the study were 45 in the communi-ty rehabilitation group and 46 in the specialized rehabilitation group.After intervention,the ADL,FMA,and BBS scores of the two groups were significantly higher than before intervention,while the modified Rankin score was significantly lower than before intervention(all P＜0.01).After intervention,there was no statistical-ly significant difference in the ADL,FMA,BBS scores,and modified Rankin scores between the two groups.After intervention,the KAP sub scores and total scores of the community rehabilitation group were significantly higher than those of the specialized rehabilitation group(all P＜0.01).The regular medication taking rate within 12 months in the community rehabilitation group was significantly higher than that in the specialized re-habilitation group(all P＜0.01),while the stroke recurrence rate and related monthly expenses after stroke were significantly lower than those in the specialized rehabilitation group(all P＜0.05).However,there was no signifi-cant difference in the incidence of falls between the two groups.Conclusion:General-Specialized combination commu-nity rehabilitation model can improve the prognosis of motor dysfunction in stroke patients,which is equivalent to the efficacy of specialized rehabilitation.It can especially improve patient treatment compliance,reduce the risk of stroke recurrence,and reduce economic burden.
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