Rehabilitation Centre Het Roessingh, Enschede, The Netherlands.
Spinal Cord. 2013 Feb;51(2):161-4. doi: 10.1038/sc.2012.95.
Retrospective cohort study.
To assess development of arm hand skilled performance (AHSP) during and after in-patient rehabilitation in persons with cervical spinal cord injury (CSCI) and to determine factors that influence the outcome.
Eight rehabilitation centres in the Netherlands with specialised spinal cord injury departments.
AHSP was assessed using the Van Lieshout test (VLT) in persons admitted with recent CSCI. Assessment was carried out at the beginning (t1), after 3 months (t2), at the end (t3) of in-patient rehabilitation, and 1 and 5 years thereafter (t4, t5). Multilevel regression analysis was performed to determine development of AHSP and associations between AHSP and age, gender, motor completeness, lesion level (high or low CSCI), motor scores of upper extremity (MSUE), and pain in the tested arm.
Fifty-five participants were included with mean age 38 years (range 18–64). There were 73% male, 80% had high CSCI (C3–C6) and 69% had motor complete lesion. Scores of VLT improved significantly during in-patient rehabilitation (mean: t1=25; t3=33) (P=0.005), scores remained unchanged at 1 year (t4=32) and 5 years (t5=32) (P=0.903) after in-patient rehabilitation. Motor completeness, MSUE and pain were significantly related to the VLT score (P<0.001, P<0.001, P=0.015, respectively). Age, gender and lesion level had no significant relationship.
AHSP improved during in-patient rehabilitation. It was then stable during the next 5 years after discharge. Persons with an incomplete lesion, high MSUE and no pain in the tested arm perform best on the VLT.
回顾性队列研究。
评估颈脊髓损伤（CSCI）患者住院康复期间和之后手臂手部熟练表现（AHSP）的发展，并确定影响结果的因素。
荷兰 8 个设有脊髓损伤专科的康复中心。
使用 Van Lieshout 测试（VLT）对新近确诊为 CSCI 的患者进行 AHSP 评估。在住院前（t1）、3 个月后（t2）、住院结束时（t3）以及之后 1 年和 5 年（t4、t5）进行评估。采用多水平回归分析来确定 AHSP 的发展以及 AHSP 与年龄、性别、运动完整性、损伤水平（高位或低位 CSCI）、上肢运动评分（MSUE）和受测手臂疼痛之间的关系。
共纳入 55 名参与者，平均年龄 38 岁（范围 18-64 岁）。其中 73%为男性，80%为高位 CSCI（C3-C6），69%为运动完全性损伤。VLT 评分在住院康复期间显著提高（平均：t1=25；t3=33）（P=0.005），在出院后 1 年（t4=32）和 5 年（t5=32）时保持不变（P=0.903）。运动完整性、MSUE 和疼痛与 VLT 评分显著相关（P<0.001、P<0.001、P=0.015）。年龄、性别和损伤水平与 VLT 评分无显著关系。
AHSP 在住院康复期间有所提高。之后在出院后的 5 年内保持稳定。运动不完全性损伤、高 MSUE 和受测手臂无疼痛的患者在 VLT 上表现最佳。
