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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
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.
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.
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