Fujino Yuji, Amimoto Kazu, Sugimoto Satoshi, Fukata Kazuhiro, Inoue Masahide, Uchino Akira, Takahashi Hidetoshi, Makita Shigeru
Department of Rehabilitation, Saitama Medical University International Medical Center: 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan.
Department of Physical Therapy, Tokyo Metropolitan University, Japan.
J Phys Ther Sci. 2017 Dec;29(12):2116-2120. doi: 10.1589/jpts.29.2116. Epub 2017 Dec 7.
[Purpose] The relationship between white matter lesions (WMLs) and pushing behavior (PB) is still poorly understood. The purpose of this study was to investigate whether damage from WMLs affects the functional outcome of PB after acute stroke. [Subjects and Methods] In total, 37 patients were included. PB was assessed using the standardized Scale for Contraversive Pushing (SCP). Stroke types were classified as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), or lacunar syndrome using the Bamford classification. WML severity was categorized into four groups using the Fazekas visual scale. Thereafter, patients were divided into 4 groups according to the stroke type and/or presence of WMLs. The SCP, Trunk Control Test (TCT), Stroke Impairment Assessment Set (SIAS), and Barthel Index were the outcome measures. [Results] The SCP and TCT in patients with PACI without WMLs were better than those in patients with TACI with or without WMLs. Regarding SCP, TCT, and SIAS, patients with TACI had poorer values compared with PACI, regardless of WML severity. Barthel Index efficiency was not significantly different between the groups. [Conclusion] Our results suggest that moderate to severe WMLs and PACI had a relationship with PB severity and truncal balance.
[目的] 对白质病变（WMLs）与推挤行为（PB）之间的关系仍知之甚少。本研究旨在探讨WMLs造成的损伤是否会影响急性卒中后PB的功能转归。[对象与方法] 共纳入37例患者。使用标准化的对侧推挤量表（SCP）评估PB。采用班福德分类法将卒中类型分为完全前循环梗死（TACI）、部分前循环梗死（PACI）或腔隙综合征。使用法泽卡斯视觉量表将WML严重程度分为四组。此后，根据卒中类型和/或是否存在WMLs将患者分为4组。观察指标包括SCP、躯干控制测试（TCT）、卒中损伤评定量表（SIAS）和巴氏指数。[结果] 无WMLs的PACI患者的SCP和TCT优于有或无WMLs的TACI患者。关于SCP、TCT和SIAS，无论WML严重程度如何，TACI患者的值均低于PACI患者。各组间巴氏指数效率无显著差异。[结论] 我们的结果表明，中度至重度WMLs和PACI与PB严重程度和躯干平衡有关。
