Randomized Controlled Trial of Early Rehabilitation After Intracerebral Hemorrhage Stroke Difference in Outcomes Within 6 Months of Stroke

被引:107
作者
Liu, Ning [1 ,2 ,3 ]
Cadilhac, Dominique A. [5 ,6 ]
Andrew, Nadine E. [5 ]
Zeng, Lingxia [4 ]
Li, Zongfang [7 ]
Li, Jin [1 ,2 ,3 ]
Li, Yan [7 ]
Yu, Xuewen [8 ]
Mi, Baibing [4 ]
Li, Zhe [9 ]
Xu, Honghai [10 ]
Chen, Yangjing [8 ]
Wang, Juan [8 ]
Yao, Wanxia [8 ]
Li, Kuo [8 ]
Yan, Feng [10 ]
Wang, Jue [1 ,2 ,3 ]
机构
[1] Xi An Jiao Tong Univ, Minist Educ, Key Lab Biomed Informat Engn, Xian 710049, Shaanxi Provinc, Peoples R China
[2] Xi An Jiao Tong Univ, Res Ctr Rehabil Sci & Technol, Sch Life Sci & Technol, Xian 710049, Shaanxi Provinc, Peoples R China
[3] Xi An Jiao Tong Univ, Natl Engn Res Ctr Hlth Care & Med Devices, Xian 710049, Shaanxi Provinc, Peoples R China
[4] Xi An Jiao Tong Univ, Dept Publ Hlth, Coll Med, Xian 710049, Shaanxi Provinc, Peoples R China
[5] Monash Univ, Sch Clin Sci, Dept Med, Translat Publ Hlth Unit, Clayton, Vic, Australia
[6] Florey Inst Neurosci & Mental Hlth, Stroke Div, Heidelberg, Vic, Australia
[7] Xi An Jiao Tong Univ, Affiliate Hosp 2, Xian 710049, Shaanxi Provinc, Peoples R China
[8] Xi An Jiao Tong Univ, Affiliate Hosp 1, Xian 710049, Shaanxi Provinc, Peoples R China
[9] China Telecom, Shaanxi Branch, Xian, Shaanxi Provinc, Peoples R China
[10] Xi An Jiao Tong Univ, Affiliate Hosp 3, Xian 710049, Shaanxi Provinc, Peoples R China
基金
中国国家自然科学基金; 英国医学研究理事会;
关键词
cerebral hemorrhage; clinical trial; randomized; outcome assessment (health care); rehabilitation; EARLY MOBILIZATION; AVERT; CHINA; CARE;
D O I
10.1161/STROKEAHA.114.005661
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Background and Purpose-Mechanisms, acute management, and outcomes for patients who experience intracerebral hemorrhage may differ from patients with ischemic stroke. Studies of very early rehabilitation have been mainly undertaken in patients with ischemic stroke, and it is unknown if benefits apply to those with intracerebral hemorrhage. We hypothesized that early rehabilitation, within 48 hours of stroke, would improve survival and functional outcomes in patients with intracerebral hemorrhage. Methods-This was a multicenter, randomized controlled study, with blinded assessment of outcome at 3 and 6 months. Eligible patients were randomized to receive standard care or standard care plus early rehabilitation. Primary outcome includes survival. Secondary outcomes includes health-related quality of life using the 36-item Short Form Questionnaire, function measured with the modified Barthel Index, and anxiety measured with the Zung Self-Rated Anxiety Scale. Results-Two hundred forty-three of 326 patients were randomized (mean age, 59 years; 56% men). At 6 months, patients receiving standard care were more likely to have died (adjusted hazard ratio, 4.44; 95% confidence interval [CI], 1.24-15.87); for morbidity outcomes, a 6-point difference in the Physical Component Summary score of the 36-item Short Form Questionnaire (95% CI, 4.2-8.7), a 7-point difference for the Mental Component Summary score (95% CI, 4.5-9.5), a 13-point difference in Modified Barthel Index scores (95% CI, 6.8-18.3), and a 6-point difference in Self-Rating Anxiety Scale scores (95% CI, 4.4-8.3) was reported in favor of the intervention groups. Conclusions-For the first time, we have shown that commencing rehabilitation within 48 hours of intracerebral hemorrhage improves survival and functional outcomes at 6 months after stroke in hospitalized patients in China.
引用
收藏
页码:3502 / 3507
页数:6
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