Huertas Hoyas E, Pedrero Pérez E J, Águila Maturana A M, García López-Alberca S, González Alted C
Universidad Rey Juan Carlos, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Alcorcón, Madrid, España.
Instituto de Adicciones de Madrid, Ayuntamiento de Madrid, Madrid, España.
Neurologia. 2015 Jul-Aug;30(6):339-46. doi: 10.1016/j.nrl.2014.01.001. Epub 2014 Feb 21.
Most individuals who have survived an acquired brain injury present consequences affecting the sensorimotor, cognitive, affective or behavioural components. These deficits affect the proper performance of daily living activities. The aim of this study is to identify functional differences between individuals with unilateral acquired brain injury using functional independence, capacity, and performance of daily activities.
Descriptive cross-sectional design with a sample of 58 people, with right-sided injury (n=14 TBI; n=15 stroke) or left-sided injury (n = 14 TBI, n = 15 stroke), right handed, and with a mean age of 47 years and time since onset of 4 ± 3.65 years. The functional assessment/functional independence measure (FIM/FAM) and the International Classification of Functioning (ICF) were used for the study.
The data showed significant differences (P<.000), and a large size effect (dr=0.78) in the cross-sectional estimates, and point to fewer restrictions for patients with a lesion on their right side. The major differences were in the variables 'speaking' and 'receiving spoken messages' (ICF variables), and 'Expression', 'Writing' and 'intelligible speech' (FIM/FAM variables). In the linear regression analysis, the results showed that only 4 FIM/FAM variables, taken together, predict 44% of the ICF variance, which measures the ability of the individual, and up to 52% of the ICF, which measures the individual's performance. Gait alone predicts a 28% of the variance.
It seems that individuals with acquired brain injury in the left hemisphere display important differences regarding functional and communication variables. The motor aspects are an important prognostic factor in functional rehabilitation.
大多数获得性脑损伤幸存者都会出现影响感觉运动、认知、情感或行为成分的后果。这些缺陷会影响日常生活活动的正常进行。本研究的目的是通过日常生活活动的功能独立性、能力和表现,确定单侧获得性脑损伤个体之间的功能差异。
采用描述性横断面设计,样本为58人,包括右侧损伤(n = 14例创伤性脑损伤;n = 15例中风)或左侧损伤(n = 14例创伤性脑损伤,n = 15例中风),右利手,平均年龄47岁,发病时间为4±3.65年。本研究使用功能评估/功能独立性测量(FIM/FAM)和国际功能分类(ICF)。
数据显示横断面估计存在显著差异(P <.000)和较大的效应量(dr = 0.78),表明右侧病变患者的限制较少。主要差异在于“说话”和“接收语音信息”(ICF变量),以及“表达”、“书写”和“可理解语音”(FIM/FAM变量)。在线性回归分析中,结果表明,仅4个FIM/FAM变量共同预测了44%的ICF方差(衡量个体能力),以及高达52%的ICF方差(衡量个体表现)。仅步态就能预测28%的方差。
似乎左半球获得性脑损伤个体在功能和沟通变量方面存在重要差异。运动方面是功能康复的一个重要预后因素。