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慢性卒中患者行走时下肢运动协调性显著受损:一项横断面研究。

Lower-limb motor coordination is significantly impaired in ambulatory people with chronic stroke: A cross-sectional study.

作者信息

Menezes Kênia K P, Nascimento Lucas R, Pinheiro Marina B, Scianni Aline A, Faria Christina D C M, Avelino Patrick R, Faria-Fortini Iza, Teixeira-Salmela Luci F

机构信息

Department of Physical Therapy , Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

出版信息

J Rehabil Med. 2017 Apr 6;49(4):322-326. doi: 10.2340/16501977-2215.

Abstract

OBJECTIVES

To establish the deficits of motor coordination of the lower limbs after stroke, in comparison with healthy controls, and to investigate whether the magnitude of the deficits would be influenced by the levels of motor recovery.

DESIGN

Cross-sectional study.

SUBJECTS

Chronic stroke patients and healthy subjects.

METHODS

Lower-limb motor coordination of both stroke and healthy volunteers was measured using the Lower Extremity Motor Coordination Test (LEMOCOT). The motor coordination deficits of the participants with stroke were analysed all together and separated, according to their levels of motor recovery, measured using the Fugl-Meyer lower-limb motor section scores.

RESULTS

Ninety-seven individuals with chronic stroke, 55 men, mean age 58 years, were evaluated. Motor coordination was significantly impaired on both paretic (mean: -22 touches; 95% confidence interval (95% CI) -24 to -19; deficit: 61%) and non-paretic (mean -6 touches; 95% CI -8 to -4; deficit: 17%) lower limbs. Significant differences in the LEMOCOT scores were found between the levels of motor recovery (p < 0.01), except between the participants with marked and moderate impairments.

CONCLUSION

Motor coordination of the lower limbs is significantly impaired after stroke, but the deficits of the non-paretic lower limb (17%) appear not to be clinically relevant. These findings suggest that interventions prescribed to improve motor coordination after stroke should focus on the paretic lower limb and/or include bilateral activities.

摘要

目的

与健康对照组相比,确定中风后下肢运动协调性的缺陷,并研究这些缺陷的严重程度是否会受到运动恢复水平的影响。

设计

横断面研究。

研究对象

慢性中风患者和健康受试者。

方法

使用下肢运动协调测试(LEMOCOT)测量中风患者和健康志愿者的下肢运动协调性。根据使用Fugl-Meyer下肢运动部分评分法测量的运动恢复水平,对中风参与者的运动协调缺陷进行综合分析和分组分析。

结果

对97名慢性中风患者进行了评估,其中55名男性,平均年龄58岁。患侧下肢(平均:-22次触碰;95%置信区间(95%CI)-24至-19;缺陷率:61%)和非患侧下肢(平均-6次触碰;95%CI -8至-4;缺陷率:17%)的运动协调性均显著受损。除了明显损伤和中度损伤的参与者之间,在运动恢复水平之间发现LEMOCOT评分存在显著差异(p<0.01)。

结论

中风后下肢运动协调性显著受损,但非患侧下肢17%的缺陷似乎与临床无关。这些发现表明,为改善中风后运动协调性而规定的干预措施应侧重于患侧下肢和/或包括双侧活动。

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