Meyer Sarah, De Bruyn Nele, Lafosse Christophe, Van Dijk Margaretha, Michielsen Marc, Thijs Liselot, Truyens Veronik, Oostra Kristine, Krumlinde-Sundholm Lena, Peeters Andre, Thijs Vincent, Feys Hilde, Verheyden Geert
KU Leuven-University of Leuven, Leuven, Belgium
KU Leuven-University of Leuven, Leuven, Belgium.
Neurorehabil Neural Repair. 2016 Sep;30(8):731-42. doi: 10.1177/1545968315624779. Epub 2015 Dec 29.
A thorough understanding of the presence of different upper-limb somatosensory deficits poststroke and the relation with motor performance remains unclear. Additionally, knowledge about the relation between somatosensory deficits and visuospatial neglect is limited.
To investigate the distribution of upper-limb somatosensory impairments and the association with unimanual and bimanual motor outcomes and visuospatial neglect.
A cross-sectional observational study was conducted, including 122 patients within 6 months after stroke (median = 82 days; interquartile range = 57-133 days). Somatosensory measurement included the Erasmus MC modification of the (revised) Nottingham Sensory Assessment (Em-NSA), Perceptual Threshold of Touch (PTT), thumb finding test, 2-point discrimination, and stereognosis subscale of the NSA. Upper-limb motor assessment comprised the Fugl-Meyer assessment, motricity index, Action Research Arm Test, and Adult-Assisting Hand Assessment Stroke. Screening for visuospatial neglect was performed using the Star Cancellation Test.
Upper-limb somatosensory impairments were common, with prevalence rates ranging from 21% to 54%. Low to moderate Spearman ρ correlations were found between somatosensory and motor deficits (r = 0.22-0.61), with the strongest associations for PTT (r = 0.56-0.61) and stereognosis (r = 0.51-0.60). Visuospatial neglect was present in 27 patients (22%). Between-group analysis revealed somatosensory deficits that occurred significantly more often and more severely in patients with visuospatial neglect (P < .05). Results showed consistently stronger correlations between motor and somatosensory deficits in patients with visuospatial neglect (r = 0.44-0.78) compared with patients without neglect (r = 0.08-0.59).
Somatosensory impairments are common in subacute patients poststroke and are related to motor outcome. Visuospatial neglect was associated with more severe upper-limb somatosensory impairments.
对于中风后不同上肢体感缺陷的存在情况及其与运动表现的关系，目前仍缺乏全面的了解。此外，关于体感缺陷与视觉空间忽视之间关系的认识也较为有限。
研究上肢体感障碍的分布情况，以及与单手和双手运动结果及视觉空间忽视的相关性。
进行了一项横断面观察性研究，纳入了122例中风后6个月内的患者（中位数 = 82天；四分位间距 = 57 - 133天）。体感测量包括伊拉斯姆斯医学中心对（修订版）诺丁汉感觉评估的修改版（Em - NSA）、触觉感知阈值（PTT）、拇指定位测试、两点辨别以及诺丁汉感觉评估的实体觉分量表。上肢运动评估包括Fugl - Meyer评估、运动指数、动作研究臂测试和成人辅助手评估中风版。使用星形删除测试进行视觉空间忽视的筛查。
上肢体感障碍很常见，患病率在21%至54%之间。体感和运动缺陷之间存在低到中度的Spearman ρ相关性（r = 0.22 - 0.61），其中与PTT（r = 0.56 - 0.61）和实体觉（r = 0.51 - 0.60）的相关性最强。27例患者（22%）存在视觉空间忽视。组间分析显示，视觉空间忽视患者的体感缺陷发生频率更高且更严重（P <.05）。结果表明，与无忽视的患者（r = 0.08 - 0.59）相比，有视觉空间忽视的患者运动和体感缺陷之间的相关性始终更强（r = 0.44 - 0.78）。
体感障碍在中风后亚急性期患者中很常见，且与运动结果相关。视觉空间忽视与更严重的上肢体感障碍有关。
