脳卒中発症後の自宅退院患者に対するテレリハビリテーションによる運動と健康関連QOLへの効果

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2025-06-16 国立循環器病研究センター

国立循環器病研究センターが主導した国際臨床試験CHARMのサブ解析で、糖尿病薬グリベンクラミドの静注が、虚血サイズ125mL以下の広汎脳梗塞患者に対し有意な後遺症軽減効果を示すことが明らかになりました。全体では効果が認められなかったものの、該当群では90日後の機能的転帰が改善。特に急性期血管内治療併用群では効果が顕著でした。このサイズ基準は同センターが提唱したもので、治療戦略の最適化に寄与する可能性があります。

<関連情報>

在宅遠隔リハビリテーションが脳卒中生存者の運動機能と健康関連QOLに及ぼす影響 Effect of home-based telerehabilitation on motor function and health-related quality of life in stroke survivors

Chiaki Yokota ∙ Kiyomasa Nakatsuka ∙ Misa Takegami ∙ Kunihiro Nishimura ∙ Tatsunori Taniguchi ∙ Koichi Ito
Journal of the Neurological Sciences  Published:May 14, 2025
DOI:https://doi.org/10.1016/j.jns.2025.123541

Highlights

  • Telerehabilitation (TR) allowed delivery of high-dose rehabilitation.
  • The efficacy of poststroke TR has not been established.
  • Home-based TR for stroke survivors was feasible and improved exercise capacity.

Abstract

Background

Home-based telerehabilitation (TR) for stroke survivors is expected to fill gaps in poststroke care for improvement of functional status. The aim was to examine the efficacy of the home-based TR for enhancing motor function and health-related quality of life (HRQOL) in stroke or transient ischemic attack (TIA) survivors 3 months after disease onset (3 M).

Methods

Patients admitted from December 2021 to March 2024 who were discharged directly home with the ability to live independently were enrolled. Twenty-nine patients who agreed to participate in a 3-month home-based TR program entered the TR group. As the control group, 276 patients without TR were included. Changes in motor function and the Medical Outcomes Study 36-Item Short-Form Health Survey at 3 M were compared between the two groups after propensity score matching (PSM).

Results

One patient with a cardiac pacemaker, four who were readmitted, and one who dropped out after the first session in the TR group, and two who died, 12 who were readmitted, and 32 with incomplete data in the control group, were excluded before PSM. The data from 21 patients in the TR group and 63 in the control group were analyzed after PSM. At 3 M, increases in 6-min walking distance were more significant in the TR group than in the control group (least-square mean change, 57.9 m [95 %CI: 38.9, 76.9] vs. 16.7 m [5.6, 27.7]). No significant between-group differences were found in the HRQOL.

Conclusions

In functionally independent stroke survivors, home-based TR improved exercise capacity but not HRQOL at 3 M.

医療・健康
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