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慢性卒中幸存者上肢肌张力亢进的预测因素。

Predictive factors of hypertonia in the upper extremity of chronic stroke survivors.

作者信息

Lee GyuChang, An SeungHeon, Lee YunBok, Lee DongGeon, Park Dong-Sik

机构信息

Department of Physical Therapy, Kyungnam University, Republic of Korea.

Department of Physical Therapy, National Rehabilitation Center, Republic of Korea.

出版信息

J Phys Ther Sci. 2015 Aug;27(8):2545-9. doi: 10.1589/jpts.27.2545. Epub 2015 Aug 21.

Abstract

[Purpose] Muscle tone is known to predict the motor function of the upper extremity within 12 months after onset in stroke survivors. The aim of this study was to investigate whether motor function of the upper extremity can predict the risk of hypertonia in chronic stroke survivors, and to analyze the correlation between the two variables to determine the predictive validity. [Subjects and Methods] Forty-three chronic stroke survivors were assessed using the Modified Ashworth Scale (MAS) for elbow flexor tone, the Fugl-Meyer assessment of the upper extremity (FM-UE), and the Action Research Arm Test (ARAT) for upper extremity motor recovery and function. [Results] Elbow flexor tone (MAS≥1(+)) increased by 0.246 compared with the baseline muscle tone even at month 12 and appeared to negatively affect the motor function of the upper extremity. The cutoff value for predicting muscle tone (MAS≥1(+)) was 24 for FM-UE and 15.5 for ARAT. FM-UE had the biggest impact on elbow flexor tone (MAS≥1(+)), and the risk of elbow flexor hypertonia (MAS≥1(+)) increased 0.764-fold for a cutoff value of FM-UE≤24 compared with a cutoff value of FM-UE>24. [Conclusion] The results show that the most important variable for predicting muscle tone of the elbow flexor in stroke survivors is the FM assessment of the upper extremity.

摘要

[目的] 已知肌张力可预测中风幸存者发病后12个月内的上肢运动功能。本研究的目的是调查上肢运动功能是否可预测慢性中风幸存者的肌张力亢进风险,并分析这两个变量之间的相关性以确定预测效度。[对象与方法] 对43名慢性中风幸存者使用改良Ashworth量表(MAS)评估肘屈肌肌张力,采用上肢Fugl-Meyer评估法(FM-UE)以及用于评估上肢运动恢复和功能的动作研究上肢测试(ARAT)。[结果] 即使在第12个月时,与基线肌张力相比,肘屈肌肌张力(MAS≥1(+))仍增加了0.246,且似乎对上肢运动功能产生负面影响。预测肌张力(MAS≥1(+))的临界值,FM-UE为24,ARAT为15.5。FM-UE对肘屈肌肌张力(MAS≥1(+))影响最大,与FM-UE>24的临界值相比,FM-UE≤24的临界值使肘屈肌肌张力亢进(MAS≥1(+))的风险增加0.764倍。[结论] 结果表明,预测中风幸存者肘屈肌肌张力的最重要变量是上肢的FM评估。

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