Yi Youbin, Shim Jae Seong, Oh Byung-Mo, Seo Han Gil
From the Department of Rehabilitation Medicine, Kangbuk Samsung Hospital, Seoul (YY); Sejong Public Health Center, Sejong-si (JSS); and Department of Rehabilitation Medicine, Seoul National University Hospital (B-MO, HGS), Republic of Korea.
Am J Phys Med Rehabil. 2017 Sep;96(9):616-620. doi: 10.1097/PHM.0000000000000694.
The aim of this study was to investigate the association between grip strength on the unaffected side and post-stroke functional improvement.
A total of 127 patients with unilateral stroke were included in this study. Demographic data, clinical data on initial grip strength, initial National Institutes of Health Stroke Scale, admission and discharge Modified Barthel Index (MBI), and stroke profiles were retrospectively reviewed.
Univariate and multiple linear regression analyses were carried out to evaluate the predictive values of each variable. In the model for discharge MBI, age, initial National Institutes of Health Stroke Scale, grip strength on the unaffected side, lesion side, and admission MBI were shown to be independent predictors. Meanwhile, grip strength on the unaffected side, lesion side, and admission MBI had significant predictive values in the model for difference between admission and discharge MBI.
The current study suggests for the first time that grip strength on the unaffected side is an independent predictor for short-term functional gain and outcome after stroke. This result may change post-stroke rehabilitation strategies to emphasize exercises to prevent loss of muscle strength. In addition, this implies the possibility of a relationship between sarcopenia and post-stroke function. Further research is needed to reveal the effect of sarcopenia on stroke patients and its mechanism.
本研究旨在探讨患侧手握力与脑卒中后功能改善之间的关联。
本研究共纳入127例单侧脑卒中患者。回顾性分析了人口统计学数据、初始握力的临床数据、初始美国国立卫生研究院卒中量表、入院及出院时的改良巴氏指数（MBI）以及卒中概况。
进行单因素和多因素线性回归分析以评估各变量的预测价值。在出院时MBI模型中，年龄、初始美国国立卫生研究院卒中量表、患侧手握力、病变侧以及入院时MBI被证明是独立预测因素。同时，患侧手握力、病变侧以及入院时MBI在入院与出院时MBI差值模型中具有显著预测价值。
本研究首次表明患侧手握力是脑卒中后短期功能获得及预后的独立预测因素。这一结果可能会改变脑卒中后康复策略，强调进行预防肌肉力量丧失的锻炼。此外，这意味着肌肉减少症与脑卒中后功能之间可能存在关联。需要进一步研究以揭示肌肉减少症对脑卒中患者的影响及其机制。
