Bailey Ryan R, Lang Catherine E
Programs in Physical Therapy and Occupational Therapy, Department of Neurology, Washington University School of Medicine, St. Louis, MO.
J Rehabil Res Dev. 2013;50(9):1213-22. doi: 10.1682/JRRD.2012.12.0222.
The goal of physical rehabilitation following upper-limb (UL) impairment is functional restoration of the UL for use in daily activities. Because capacity for UL function may not translate into real-world activity, it is important that assessment of real-world UL activity be used in conjunction with clinical measures of capacity. Accelerometry can be used to quantify duration of UL activity outside of the clinic. The purpose of this study was to characterize hours of UL activity and potential modifying factors of UL activity (sedentary activity, cognitive impairment, depressive symptomatology, additive effects of comorbidities, cohabitation status, and age). Seventy-four community-dwelling adults wore accelerometers on bilateral wrists for 25 h and provided information on modifying factors. Mean time of dominant UL activity was 9.1 +/- 1.9 h, and the ratio of activity between the nondominant and dominant ULs was 0.95 +/- 0.06 h. Decreased hours of dominant UL activity was associated with increased time spent in sedentary activity. No other factors were associated with hours of dominant UL activity. These data can be used to help clinicians establish outcome goals for patients given preimpairment level of sedentary activity and to track progress during rehabilitation of the ULs.
上肢（UL）功能受损后进行物理康复的目标是恢复上肢功能，以便用于日常活动。由于上肢功能能力可能无法转化为实际的日常活动，因此将实际的上肢日常活动评估与功能能力的临床测量结合使用非常重要。加速度计可用于量化诊所外上肢活动的持续时间。本研究的目的是描述上肢活动时间以及上肢活动的潜在影响因素（久坐活动、认知障碍、抑郁症状、合并症的叠加效应、同居状况和年龄）。74名社区居住的成年人在双侧手腕佩戴加速度计25小时，并提供了有关影响因素的信息。优势上肢的平均活动时间为9.1±1.9小时，非优势上肢与优势上肢的活动时间比为0.95±0.06小时。优势上肢活动时间减少与久坐活动时间增加有关。没有其他因素与优势上肢活动时间相关。这些数据可用于帮助临床医生根据损伤前的久坐活动水平为患者制定康复目标，并在上肢康复过程中跟踪进展情况。
