Division of Neuro-rehabilitation and Recovery, National Stroke Research Institute, Florey Neuroscience Institutes, Level 2, Neurosciences Building, Heidelberg Repatriation Hospital, Austin Health, 300 Waterdale Road, Heidelberg Heights, Victoria, 3081, Australia.
J Rehabil Med. 2011 Feb;43(3):257-63. doi: 10.2340/16501977-0662.
Somatosensory loss following stroke is common, with negative consequences for functional outcome. However, existing studies typically do not include quantitative measures of discriminative sensibility. The aim of this study was to quantify the proportion of stroke patients presenting with discriminative sensory loss of the hand in the post-acute rehabilitation phase.
Prospective cohort study of stroke survivors presenting for rehabilitation.
Fifty-one consecutive patients admitted to a metropolitan rehabilitation centre over a continuous 12-month period who met selection criteria.
Quantitative measures of touch discrimination and limb position sense, with high re-test reliability, good discriminative test properties and objective criteria of abnormality, were employed. Both upper limbs were tested, in counterbalanced order.
Impaired touch discrimination was identified in the hand contralateral to the lesion in 47% of patients, and in the ipsilesional hand in 16%. Forty-nine percent showed impaired limb position sense in the contralesional limb and 20% in the ipsilesional limb. Sixty-seven percent demonstrated impairment of at least one modality in the contralesional limb. Ipsilesional impairment was less severe.
Discriminative sensory impairment was quantified in the contralesional hand in approximately half of stroke patients presenting for rehabilitation. A clinically significant number also experienced impairment in the ipsilesional "unaffected" hand.
脑卒中后感觉丧失较为常见，对功能预后有负面影响。然而，现有研究通常不包括对手部辨别感觉丧失的定量测量。本研究旨在量化在急性康复阶段出现手部辨别感觉丧失的脑卒中患者的比例。
对接受康复治疗的脑卒中幸存者进行前瞻性队列研究。
连续 12 个月内符合入选标准的 51 例入住都市康复中心的脑卒中患者。
采用具有高度重测可靠性、良好辨别测试特性和异常客观标准的定量触觉辨别和肢体位置觉测量方法。双侧上肢均进行测试，顺序为交替进行。
47%的患者对侧手出现触觉辨别受损，16%的患者同侧手出现触觉辨别受损。49%的患者对侧肢体出现肢体位置觉受损，20%的患者同侧肢体出现肢体位置觉受损。67%的患者对侧肢体至少有一种感觉模式受损。同侧肢体的损伤程度较轻。
接受康复治疗的脑卒中患者中，约有一半的患者对侧手出现辨别感觉障碍，有相当数量的患者还出现了“未受损”的同侧手感觉障碍。
