Safaz Ismail, Yilmaz Bilge, Yaşar Evren, Alaca Rdvan
Gülhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey.
Int J Rehabil Res. 2009 Sep;32(3):228-31. doi: 10.1097/MRR.0b013e32832a62ad.
The aim of this study was to find out first whether Brunnstrom recovery stage (BRS) and motricity index (MI) were correlated with each other and second to observe whether the two assessment tools were sensitive to changes regarding the rehabilitation outcome. Forty-six stroke patients who were admitted to the Stroke Rehabilitation Unit at our Rehabilitation Centre were recruited. All measurements were made within the first 72 h of admission and on the last day of discharge. A physiotherapist performed all MI evaluations and a physiatrist blind to the results performed all BRS evaluations. Both upper extremity (UE) and hand BRS scores were found to be positively correlated with those of UE-MI; moreover, correlations between the discharge values were stronger than those between the admission values. The responsiveness of both the total scores of the BRS and UE-MI were strong (effect size d = 0.97, Wilcoxon Z=5.33, P<0.001 for the UE-BRS; d=0.81, Z=5.09, P<0.001 for the hand BRS; d=0.91, Z=5.45, P<0.001 for the UE-MI). BRS and MI scores were found to be increased on discharge when compared with those of admission and the differences in between were statistically significant (P<0.001). BRS and MI seem to be well correlated and responsive concerning the evaluation of UEs in early stage stroke patients. Being convenient tests, they may easily be applied repetitively for close follow-up during rehabilitation.
本研究的目的，一是查明布鲁恩斯特伦恢复阶段（BRS）与运动功能指数（MI）是否相互关联，二是观察这两种评估工具对康复结果变化是否敏感。招募了46名入住我们康复中心卒中康复单元的卒中患者。所有测量均在入院后的头72小时内及出院的最后一天进行。所有MI评估均由一名物理治疗师进行，所有BRS评估均由一名对结果不知情的物理医学与康复医生进行。发现上肢（UE）和手部BRS评分均与UE-MI评分呈正相关；此外，出院时数值之间的相关性强于入院时数值之间的相关性。BRS总分和UE-MI的反应性均较强（效应量d = 0.97，Wilcoxon Z = 5.33，UE-BRS的P < 0.001；d = 0.81，Z = 5.09，手部BRS的P < 0.001；d = 0.91，Z = 5.45，UE-MI的P < 0.001）。与入院时相比，出院时BRS和MI评分升高，两者之间的差异具有统计学意义（P < 0.001）。对于早期卒中患者上肢的评估，BRS和MI似乎具有良好的相关性和反应性。作为简便的测试，它们可在康复期间轻松重复应用以进行密切随访。
