Wesselhoff Steven, Hanke Timothy A, Evans Christian C
a In-patient Rehabilitation Unit , University of Colorado Health Memorial Hospital , Colorado Springs , CO , USA.
b Physical Therapy Program, College of Health Sciences , Midwestern University , Downers Grove , IL , USA.
Top Stroke Rehabil. 2018 Apr;25(3):224-238. doi: 10.1080/10749357.2017.1419617. Epub 2018 Jan 11.
Background Stroke is the leading cause of severe disability and many survivors report long-term physical or cognitive impairments that may impact their ability to achieve community mobility (CM).
To determine the extent to which people with chronic stroke achieve CM compared to age-matched norms or non-neurologically impaired controls. Methods The StrokEDGE outcome measures were searched to identify validated tools that included >25% of items addressing CM. MEDLINE, CINAHL, Google Scholar, PubMed, PEDro and the Cochrane databases were searched from 2001 to 2015 with the identified outcome measures cross-referenced against search terms related to stroke and CM.
utilized a validated CM outcome measure, chronic (>3 months post) stroke survivors, and randomized controlled trial, observational or cohort study design. One reviewer screened the studies and performed data extraction and three performed quality appraisal. Fourteen studies met all inclusion criteria. Results Stroke survivors have impaired CM as demonstrated by 30-83% of normative or non-stroke subject CM scores. As time post-stroke increased, CM improved only slightly. Factors found to correlate with the CM were age, education, general well-being, emotional state, motor function and coordination, independence in activities of daily living, balance, endurance and driving status. Limitations of this review include a relatively high functioning cohort, no meta-analysis and reliance on outcome measures not specifically designed to measure CM. Conclusion Survivors of stroke may experience a significant decrease in CM compared to people without neurological injury. Rehabilitation addressing motor function, coordination, independence in activities of daily living, balance and endurance may be important for achieving higher levels of CM. Outcome measures directly addressing CM are needed.
背景 中风是导致严重残疾的主要原因，许多幸存者报告称存在长期身体或认知障碍，这可能会影响他们实现社区移动性（CM）的能力。
确定与年龄匹配的正常人群或无神经功能损害的对照组相比，慢性中风患者实现CM的程度。方法 检索StrokEDGE结局测量指标，以确定经过验证且超过25%的项目涉及CM的工具。从2001年至2015年检索MEDLINE、CINAHL、谷歌学术、PubMed、PEDro和Cochrane数据库，并将确定的结局测量指标与与中风和CM相关的检索词进行交叉引用。
采用经过验证的CM结局测量指标、慢性（中风后>3个月）中风幸存者，以及随机对照试验、观察性或队列研究设计。一名评审员筛选研究并进行数据提取，三名评审员进行质量评估。十四项研究符合所有纳入标准。结果 中风幸存者的CM受损，30%-83%的正常或非中风受试者CM得分证明了这一点。随着中风后时间的增加，CM仅略有改善。发现与CM相关的因素包括年龄、教育程度、总体幸福感、情绪状态、运动功能和协调性、日常生活活动的独立性、平衡能力、耐力和驾驶状态。本综述的局限性包括队列功能相对较高、未进行荟萃分析以及依赖并非专门设计用于测量CM的结局测量指标。结论 与无神经损伤的人相比，中风幸存者的CM可能会显著下降。针对运动功能、协调性、日常生活活动的独立性、平衡和耐力的康复训练对于实现更高水平的CM可能很重要。需要直接针对CM的结局测量指标。
