Beebe Justin A, Lang Catherine E
Washington University, St Louis, MO 63108, USA.
Stroke. 2009 May;40(5):1772-9. doi: 10.1161/STROKEAHA.108.536763. Epub 2009 Mar 5.
After stroke, 80% of patients experience acute paresis of the upper extremity and only approximately one-third achieve full functional recovery. Predicting functional recovery for these patients is highly important to provide focused, cost-effective rehabilitation. Our purpose was to examine if early measures of upper extremity active range of motion (AROM) could predict recovery of upper extremity function, and to describe the trajectory of upper extremity AROM recovery over time.
Thirty-three subjects were tested at 1 month and then at 3 months after stroke. Upper extremity function was measured with 6 standardized clinical tests that were synthesized into a single, sensitive score for upper extremity function using principal component analysis. The ability to move each segment (AROM) was measured using a 3-dimensional electromagnetic tracking system.
Stepwise multiple regression revealed that AROM of the shoulder and middle finger segments taken at 1 month could predict 71% of the variance in upper extremity function at 3 months. All segments of the upper extremity recover similarly and no evidence of a proximal to distal gradient in motor deficits appeared over time.
Simple AROM measurements of the upper extremity taken within 1 month after stroke can be used to predict upper extremity function at 3 months. This information is important for determining the prognosis of upper extremity functional recovery.
中风后,80%的患者会出现上肢急性轻瘫,只有约三分之一的患者能实现完全功能恢复。对这些患者的功能恢复进行预测对于提供有针对性的、具有成本效益的康复治疗至关重要。我们的目的是研究上肢主动活动范围(AROM)的早期测量是否能够预测上肢功能的恢复,并描述上肢AROM随时间的恢复轨迹。
33名受试者在中风后1个月和3个月时接受测试。使用6项标准化临床测试来测量上肢功能,并通过主成分分析将这些测试综合为一个针对上肢功能的单一、敏感评分。使用三维电磁跟踪系统测量每个节段的活动能力(AROM)。
逐步多元回归分析显示,1个月时测量的肩部和中指节段的AROM能够预测3个月时上肢功能变异的71%。上肢的所有节段恢复情况相似,且随着时间推移未出现运动功能缺损从近端到远端的梯度变化迹象。
中风后1个月内进行的简单上肢AROM测量可用于预测3个月时的上肢功能。该信息对于确定上肢功能恢复的预后很重要。