Lazar R B, Yarkony G M, Ortolano D, Heinemann A W, Perlow E, Lovell L, Meyer P R
Department of Neurology, Northwestern University Medical School, Chicago, IL.
Arch Phys Med Rehabil. 1989 Nov;70(12):819-22.
The relationship between early motor status and functional outcome after spinal cord injury (SCI) was evaluated prospectively in 52 quadriplegic and 26 paraplegic patients. Motor status was measured within 72 hours of injury and quantified with the Motor Index Score (MIS). Functional status was evaluated with the Modified Barthel Index (MBI). A senior physical therapist completed the MIS and the MBI when each patient was admitted to the spinal cord intensive care unit and every 30 days during rehabilitation. Early motor function was correlated with average daily improvement in functional status including self-care and mobility (p = .001). The initial MIS strongly correlated with functional status of quadriplegics at admission (p = .001), at 60 days, and at rehabilitation discharge (p = .001). In paraplegics, the overall MBI at admission, after 60 days of rehabilitation, and at discharge was not correlated with early motor function. However, the MIS correlated significantly with the MBI self-care subscore at 60 days and at discharge (p = .01), but not with the mobility subscore. The initial MIS was also significantly correlated to functional status at discharge in patients with complete lesions (p = .001), but was not related to functional status at discharge in patients with incomplete lesions. The MIS appears to be a useful tool in predicting function during rehabilitation, although individual differences in ambulation, particularly for patients with paraplegia, limit the predictive utility of this index.
对52例四肢瘫痪患者和26例截瘫患者进行了前瞻性评估，以研究脊髓损伤（SCI）后早期运动状态与功能结局之间的关系。在受伤后72小时内测量运动状态，并通过运动指数评分（MIS）进行量化。功能状态采用改良巴氏指数（MBI）进行评估。当每位患者入住脊髓重症监护病房时，以及在康复期间每30天，由一名资深物理治疗师完成MIS和MBI评估。早期运动功能与包括自我护理和活动能力在内的功能状态的每日平均改善相关（p = 0.001）。初始MIS与四肢瘫痪患者入院时（p = 0.001）、60天时以及康复出院时的功能状态密切相关（p = 0.001）。在截瘫患者中，入院时、康复60天后以及出院时的总体MBI与早期运动功能无关。然而，MIS与60天时和出院时的MBI自我护理子评分显著相关（p = 0.01），但与活动子评分无关。初始MIS与完全性损伤患者出院时的功能状态也显著相关（p = 0.001），但与不完全性损伤患者出院时的功能状态无关。MIS似乎是预测康复期间功能的一个有用工具，尽管在步行能力方面存在个体差异，尤其是截瘫患者，这限制了该指数的预测效用。
