Franck Johan Anton, Smeets Rob Johannes Elise Marie, Seelen Henk Alexander Maria
Adelante Rehabilitation Centre, dept. of brain Injury Rehabilitation, Hoensbroek, the Netherlands.
Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.
PLoS One. 2017 Jun 14;12(6):e0179453. doi: 10.1371/journal.pone.0179453. eCollection 2017.
Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated.
This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge.
Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation.
A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.
应用于中风康复的手臂-手部康复计划通常针对特定人群，因此在异质性患者群体中的适用性较低。此外，在特定且详细描述的康复治疗期间及之后，手臂-手部功能（AHF）和手臂-手部技能表现（AHSP）的变化往往没有得到很好的评估。
这项单臂前瞻性队列研究纳入了三个亚组的中风患者，其AHF分别为重度、中度或轻度受损。康复治疗包括简明中风手臂和手部康复方法（CARAS）。在入院时、临床出院时、临床出院后3、6、9和12个月进行功能和活动水平的测量。
89例中风患者（男/女：63/23；平均年龄：57.6岁（±10.6）；中风后时间：29.8天（±20.1））参与了研究。除重度受影响亚组的握力外，所有患者在康复期间及之后的AHF和手臂-手部能力均有所改善。中度受影响AHF的患者改善最大。关于自我感知的AHSP，平均而言，所有亚组均随时间有所改善。一小部分患者在康复后自我感知的AHSP有所下降。
整个手臂-手部损伤严重程度范围内的大多数中风患者在AHF、手臂-手部能力和自我感知的AHSP方面均有显著改善。这些改善在康复后长达一年的时间内得以维持。研究结果可作为未来研究的对照条件。
