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慢性中风中的本体感觉缺失-上肢功能和日常生活。

Proprioception deficits in chronic stroke-Upper extremity function and daily living.

机构信息

Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

PLoS One. 2018 Mar 30;13(3):e0195043. doi: 10.1371/journal.pone.0195043. eCollection 2018.

Abstract

BACKGROUND

Proprioception deficits are common post-stroke and predict poor functional outcome. It is unknown if the presence of proprioception deficits is negatively associated with the motor and functional ability of the affected upper extremity and daily living at the chronic stage post-stroke.

AIMS

  1. To describe proprioception deficits of individuals with chronic stroke, 2) to correlate the severity of proprioception deficits with the motor and functional ability of the upper extremity, and 3) to compare independence in basic and instrumental activities in daily living (BADL, IADL), upper extremity motor and functional abilities between individuals with and without proprioception deficits.

METHODS

102 adults aged 29-85 years with chronic stroke participated in this cross sectional study. The upper extremity was assessed for proprioception (Thumb localization Test), motor [Fugl-Meyer Motor Assessment (FMA)] and functional ability [Action Research Arm Test (ARAT), Box and Block Test (BBT)], grip strength and daily use [Motor Activity Log (MAL)]. Independence in BADL and IADL was also assessed.

RESULTS

71 participants had intact proprioception, 31 participants had mild-moderate proprioception deficits. Negative significant (p<.001) correlations were found between the severity of proprioception deficits to the motor ability (FMA) (r = -.41), functional ability (ARAT) (r = -.48), dexterity (BBT) (r = -.43), grip strength (r = -.41) and daily-use (MAL amount and quality) (r = -.55 and r = -.54, respectively) of the affected upper extremity. Significant between-group differences were found for BADL, IADL and upper extremity measures.

CONCLUSION

Proprioception deficits of individuals with chronic stroke are negatively associated with upper extremity motor and functional abilities and independence in daily living. Therefore, proprioception should be assessed at the chronic stage post-stroke.

摘要

背景

本体感觉缺陷在中风后很常见,且与不良的功能预后相关。目前尚不清楚本体感觉缺陷的存在是否与中风后慢性期患侧上肢的运动和功能能力以及日常生活活动的独立性呈负相关。

目的

1)描述慢性中风患者的本体感觉缺陷;2)分析本体感觉缺陷的严重程度与上肢运动和功能能力的相关性;3)比较有/无本体感觉缺陷患者的日常生活活动(BADL、IADL)、上肢运动和功能能力的独立性。

方法

本研究共纳入 102 名年龄 29-85 岁的慢性中风患者。使用拇指定位测试(Thumb Localization Test)评估上肢本体感觉,使用 Fugl-Meyer 运动评估(Fugl-Meyer Motor Assessment,FMA)、上肢动作研究测试(Action Research Arm Test,ARAT)、盒-块测试(Box and Block Test,BBT)评估上肢运动和功能能力,使用握力计评估握力,使用活动日志(Motor Activity Log,MAL)评估日常使用情况。同时评估 BADL 和 IADL 的独立性。

结果

71 名参与者本体感觉完整,31 名参与者存在轻度至中度本体感觉缺陷。本体感觉缺陷的严重程度与运动能力(FMA)(r = -.41)、功能能力(ARAT)(r = -.48)、灵巧性(BBT)(r = -.43)、握力(r = -.41)和日常使用(MAL 量和质量)(r = -.55 和 r = -.54)呈显著负相关(p<.001)。在 BADL、IADL 和上肢测量方面,有/无本体感觉缺陷的患者之间存在显著的组间差异。

结论

慢性中风患者的本体感觉缺陷与上肢运动和功能能力以及日常生活活动的独立性呈负相关。因此,应在中风后慢性期评估本体感觉。

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