Pappalardo A, Ciancio M R, Patti F
Physical Medicine and Rehabilitation Center, Ospedale S. Marta & S. Venera, Acireale, Catania, Italy Departement of Neuroscience, University of Catania, Catania, Italy.
Physical Medicine and Rehabilitation Center, Ospedale S. Pietro, Caltagirone, Catania, Italy.
NeuroRehabilitation. 2014 Jan 1;35(2):215-20. doi: 10.3233/NRE-141109.
Basic trunk movement control is often impaired after stroke and its recovery is a "miliary stone" in rehabilitation.
In this prospective, observational, parallel-group study, we investigated whether there are differences in terms of post-stroke recovery of basic trunk control between patients with left or with right hemiparesis.
We recruited 94 patients with loss of postural trunk control due to stroke. Patients were divided into Group A (48 patients with left hemiparesis) and Group B (46 patients with right hemiparesis). We administered the Trunk Control Test (TCT) and the 13 motor items included on the Functional Independence Measure. Evaluation was performed at admission (To) and discharge (T1).
TCT increased respectively from 46.7 ± 23.3 to 62.6 ± 19.5 (mean ± standard deviation-SD, p < 0.0001) in Group A and from 49.4 ± 23.2 to 79.1 ± 14.4 (mean ± SD, p < 0.0001) in Group B. TCT resulted significantly higher in Group B than in Group A, at T1 (p < 0.0001). No significant difference was found for motFIM at T1.
Side of hemiparesis could affect the degree of recovery of basic trunk control after stroke. Patients with right hemiparesis benefit more than those with left hemiparesis. Improvement of basic trunk control was not responsible for an advantage on functional independence.
脑卒中后基本躯干运动控制常受损,其恢复是康复领域的“棘手难题”。
在这项前瞻性、观察性、平行组研究中,我们调查了左偏瘫或右偏瘫患者在脑卒中后基本躯干控制恢复方面是否存在差异。
我们招募了94例因脑卒中导致姿势性躯干控制丧失的患者。患者被分为A组(48例左偏瘫患者)和B组(46例右偏瘫患者)。我们进行了躯干控制测试(TCT)以及功能独立性测量中包含的13项运动项目。在入院时(T0)和出院时(T1)进行评估。
A组TCT分别从46.7±23.3提高到62.6±19.5(平均值±标准差-SD,p<0.0001),B组从49.4±23.2提高到79.1±14.4(平均值±SD,p<0.0001)。在T1时,B组的TCT显著高于A组(p<0.0001)。在T1时,motFIM未发现显著差异。
偏瘫侧可能影响脑卒中后基本躯干控制的恢复程度。右偏瘫患者比左偏瘫患者受益更多。基本躯干控制的改善并非功能独立性优势的原因。