Paci Matteo, Nannetti Luca, Casavola Davide, Lombardi Bruna
aUnit of Functional Rehabilitation, Azienda USL Toscana Centro, Prato bPrivate Practitioner cSchool of Specialization in Physical Medicine and Rehabilitation, Unit of Functional Rehabilitation, Azienda USL Toscana Centro, University of Florence, Florence, Italy.
Int J Rehabil Res. 2016 Jun;39(2):185-7. doi: 10.1097/MRR.0000000000000172.
Previous studies comparing the patterns of recovery for upper (UL) and lower limbs (LL) reported similar patterns of motor recovery of extremities. However, the influence of clinical stroke subtypes on the difference between recovery of extremities has never been investigated. The aim of this study is to compare the time course of the UL and LL in a sample of patients who have had distinct subtypes of ischemic stroke. A total of 443 consecutive patients following ischemic stroke were assessed at admission, discharge, and 1 month after discharge with the arm and leg motor parts of the Fugl-Meyer scale. Separate analyses were carried out for the entire sample and for samples of each stroke subtype classified according to the Oxfordshire Community Stroke Project. All groups showed significant improvements in motor function (P<0.001). Within the group of patients with total anterior circulation infarcts, the LL showed greater improved motor recovery than the UL (P<0.001). No significant difference was found between the time course of UL and LL motor recovery in the entire sample and in the other groups. This study confirms similar motor recovery of limbs in the entire sample, but also shows that the LL has greater recovery than the UL in patients with total anterior circulation infarcts. Functional prognosis should take into account the distinct stroke subtypes.
以往比较上肢（UL）和下肢（LL）恢复模式的研究报告称，四肢的运动恢复模式相似。然而，临床卒中亚型对四肢恢复差异的影响从未得到研究。本研究的目的是比较患有不同亚型缺血性卒中的患者样本中上肢和下肢的恢复时间进程。对443例连续缺血性卒中患者在入院时、出院时和出院后1个月使用Fugl-Meyer量表的手臂和腿部运动部分进行评估。对整个样本以及根据牛津郡社区卒中项目分类的每种卒中亚型的样本分别进行分析。所有组的运动功能均有显著改善（P<0.001）。在全前循环梗死患者组中，下肢的运动恢复改善程度大于上肢（P<0.001）。在整个样本和其他组中，上肢和下肢运动恢复的时间进程未发现显著差异。本研究证实了整个样本中四肢的运动恢复相似，但也表明在全前循环梗死患者中，下肢的恢复程度大于上肢。功能预后应考虑不同的卒中亚型。
