五种手臂功能测量在急性脑卒中康复中的反应性。

Responsiveness of five measures of arm function in acute stroke rehabilitation.

机构信息

1 Musculoskeletal Health Sydney, School of Public Health, The University of Sydney, Sydney, NSW, Australia.

2 Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.

出版信息

Clin Rehabil. 2018 Aug;32(8):1098-1107. doi: 10.1177/0269215518778316. Epub 2018 May 30.

DOI:10.1177/0269215518778316

PMID:29843521

Abstract

OBJECTIVE

To determine the responsiveness of five arm function measures in people receiving acute inpatient stroke rehabilitation.

DESIGN

Inception cohort study.

SETTING

Comprehensive stroke unit providing early rehabilitation.

SUBJECTS

A total of 64 consecutively admitted stroke survivors with moderately severe disability (Modified Rankin Scale score median (interquartile range (IQR)): 4.0 (1.0)).

MAIN MEASURES

Responsiveness was analyzed by calculating effect size, standardized response mean and median-based effect size. Floor/ceiling effects were calculated as the percentage of participants scoring the lowest/highest possible scores.

RESULTS

Average length of stay and number of therapy days were 34 (SD = 27.9) and 12 (SD = 13.1), respectively. Box and Block Test and Functional Independence Measure-Self-Care showed the highest responsiveness with values in the moderate-large range (effect size = 1.09, standardized response mean = 1.07 and median-based effect size = 0.76; effect size = 0.94, standardized response mean = 1.04 and median-based effect size = 1.0). Responsiveness of Action Research Arm Test and Upper Limb-Motor Assessment Scale were moderate (effect size = 0.58, standardized response mean = 0.69 and median-based effect size = 0.59; effect size = 0.62, standardized response mean = 0.75 and median-based effect size = 0.67). For Manual Muscle Test, responsiveness was in the small-moderate range (effect size = 0.42, standardized response mean = 0.59 and median-based effect size = 0.5). Box and Block Test showed the largest floor effect on admission (28%), and Action Research Arm Test and Manual Muscle Test showed the largest ceiling effect on discharge (31%).

CONCLUSION

These five measures varied in their ability to detect change with responsiveness ranging from the small to large range. Box and Block Test and Functional Independence Measure-Self-Care showed a greater ability to detect change; both demonstrated moderate-large responsiveness.

摘要

目的

确定五项手臂功能测量在接受急性住院卒中康复治疗的患者中的反应能力。

设计

起点队列研究。

地点

提供早期康复的综合卒中单元。

受试者

共纳入 64 例连续入院的中度残疾卒中幸存者（改良 Rankin 量表评分中位数（四分位距（IQR））：4.0（1.0））。

主要措施

通过计算效应量、标准化反应均值和基于中位数的效应量来分析反应能力。地板/天花板效应的计算方法是得分最低/最高的参与者百分比。

结果

平均住院时间和治疗天数分别为 34（SD=27.9）和 12（SD=13.1）。箱式和区块测试和功能性独立性测量自我护理显示出最高的反应能力，其值处于中到大范围（效应量=1.09，标准化反应均值=1.07，基于中位数的效应量=0.76；效应量=0.94，标准化反应均值=1.04，基于中位数的效应量=1.0）。动作研究手臂测试和上肢运动评估量表的反应能力为中度（效应量=0.58，标准化反应均值=0.69，基于中位数的效应量=0.59；效应量=0.62，标准化反应均值=0.75，基于中位数的效应量=0.67）。对于手动肌肉测试，反应能力处于小到中度范围（效应量=0.42，标准化反应均值=0.59，基于中位数的效应量=0.5）。箱式和区块测试在入院时的地板效应最大（28%），动作研究手臂测试和手动肌肉测试在出院时的天花板效应最大（31%）。