تاثير تحريكات حسي زود هنگام خانواده محور بر ميزان ناتواني بيماران مبتلا به سكته مغزي

Effects of Early Family-centered Sensory Stimulation on Disability and Rehabilitation of Stroke Patients

سابقه و هدف: سكته مغزي شايع‌ترين و ناتوان‌كننده‌ترين ضايعه نورولوژيكي در بزرگسالان است. تحريكات حسي زود هنگام و خانواده‌محور بعد از بروز سكته مغزي تاثير مثبتي در روند بهبودي اين بيماران دارد. هدف اين مطالعه بررسي تاثير تحريكات حسي زودهنگام خانواده محور بر بهبودي عملكرد و ناتواني بيماران سكته مغزي بود. مواد و روش‌ها: اين كارآزمايي باليني، بر60 بيمار دچار اختلال هوشياري ناشي از سكته مغزي (8-10(GCS= بستري در بخش ICU انجام شد. بيماران طبق بلوك‌بندي تصادفي به دو گروه 30 نفره آزمون و كنترل تقسيم شدند. گروه آزمون، مراقبت‌هاي روتين بخش ICU و تحريكات حسي پنجگانه توسط اعضاي خانواده به مدت 14 روز و گروه كنترل تنها مراقبت‌هاي روتين ICU دريافت نمودند. سطح هوشياري بيماران قبل از شروع مداخله و در روزهاي 5، 10 و 15 با GCS و FOUR و ميزان ناتواني و عملكرد شناختي با DRS ارزيابي شدند. يافته‌ها: تحريكات حسي انجام شده باعث افزايش معناداري در ميانگين نمره عملكردشناختي بيماران در گروه آزمون نسبت به گروه كنترل گرديد (0/001

Background and purpose: Stroke is the most common and debilitating neurologic lesion in adults. Early family-centered stimulation have positive outcomes in stroke patients. The present study was designed to investigate the effect of early family-centered sensory stimulation on restoring function and recognition in stroke patients. Materials and methods: A clinical trial was done in 60 patients with impaired consciousness due to stroke (GCS=5-10) admitted in intensive care unit (ICU). The participants were assigned into control and experimental groups (n=30 per group) using randomized block design. The experimental group received sensory stimulations of the five senses in the first 48-72 hours after the stroke by family members for 14 days. The control group received ICU routine care. At days 5, 10, and 15, the consciousness level was assessed by GCS and FOUR and cognitive function was assessed by Disability Rating Scale. Results: Sensory stimulations significantly increased the mean score for cognitive function in the experimental group compared to the control group (P<0.001). The effect sizes of cognitive function at days 5, 10 and 15 were 0.45, 0.95, and 1.09, respectively. The effect sizes were small at day 5 and large at days 10 and 15. No significant differences were observed in the level of consciousness (P=0.601) and function (P=0.710). Conclusion: In current study, early family-centered sensory stimulation in patients with impaired consciousness due to stroke improved their cognitive function but did not significantly influence their disability score.