Doruk Pınar
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Kazım Karabekir Cad. Gülhatmi Cad. 4227, Adana, Turkey.
J Back Musculoskelet Rehabil. 2013;26(2):207-11. doi: 10.3233/BMR-130370.
To investigate the effects of knee osteoarthritis (OA) on activities of daily living and motor and functional improvement in stroke patients with hemiparesis.
This prospective case-controlled study included 60 inpatients (44 women, 16 men; mean age 66.1 ± 7.6 years, range 51-79 years) with hemiparesis after stroke. Main outcome measures included the Brunnstrom motor recovery stages of the lower extremity, Functional Ambulation Category (FAC), Barthel index, knee pain as assessed by a VAS, and radiographic severity of knee OA based on the Kellgren-Lawrence (K/L) criteria.
Between improvements in FAC score and time since stroke , Barthel score, knee pain at rest, K/L radiological grade revealed weak but significant correlations (r: 0.254-0.393) (p< 0.05). Regression analysis revealed that time since stroke, knee pain at rest and radiologically knee osteoarthritis had a significant effect on the improvement in ambulation level (r=0.134, p=0.001; r=0.137, p<0.05; r=-0.007, p< 0.05; respectively).
The present study shows that knee OA had a negative effect on ambulation levels in hemiplegic patients after stroke. Thus, knee pain at rest and knee osteoarthritis could be evaluated as a functional outcome factor for the improvement of the ambulation levels within stroke patients.
探讨膝骨关节炎（OA）对中风偏瘫患者日常生活活动能力以及运动和功能改善的影响。
这项前瞻性病例对照研究纳入了60例中风后偏瘫的住院患者（44例女性，16例男性；平均年龄66.1±7.6岁，范围51 - 79岁）。主要结局指标包括下肢Brunnstrom运动恢复阶段、功能性步行分类（FAC）、Barthel指数、视觉模拟评分法（VAS）评估的膝关节疼痛，以及基于Kellgren-Lawrence（K/L）标准的膝关节OA影像学严重程度。
FAC评分的改善与中风后的时间、Barthel评分、静息时膝关节疼痛、K/L放射学分级之间存在微弱但显著的相关性（r：0.254 - 0.393）（p < 0.05）。回归分析显示，中风后的时间、静息时膝关节疼痛和放射学上的膝关节骨关节炎对步行水平的改善有显著影响（r分别为0.134，p = 0.001；r = 0.137，p < 0.05；r = -0.007，p < 0.05）。
本研究表明，膝OA对中风后偏瘫患者的步行水平有负面影响。因此，静息时膝关节疼痛和膝关节骨关节炎可作为评估中风患者步行水平改善的功能结局因素。
