Kongsawasdi Siriphan, Klaphajone Jakkrit, Watcharasaksilp Kanokwan, Wivatvongvana Pakorn
Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
ScientificWorldJournal. 2018 May 2;2018:4708230. doi: 10.1155/2018/4708230. eCollection 2018.
Although lateralization of the brain affects some specialized cortical functions, there are still limited data to address its influence on clinically important outcomes. This study aimed to reveal the prognostic variables that relate to functional recovery in stroke patients with a left-sided hemispheric lesion during 6 months of follow-up. Data from 167 left-sided and 183 right-sided hemispheric strokes were reviewed retrospectively. Outcomes in this study included walking capacity and functional recovery, assessed by the modified Rankin Scale (mRS). In order to obtain independent predictive variables, this study used the step-backward method of multivariable regression analysis of parameters. The final model demonstrated that motor function of the hemiparetic leg was the strongest independent predictor for both walking ability and functional recovery (risk ratio (RR) of 2.41, 95% CI: 1.61-3.60, and < 0.001 and RR of 1.83, 95% CI: 1.03-3.26, and = 0.04, resp.). Therefore, lateralization did not seem to be involved. Understanding predictable variables that are associated with recovery can guide the rehabilitation team in setting priority and appropriate treatment for stroke patients.
尽管大脑的功能侧化会影响一些特定的皮质功能，但关于其对临床重要预后影响的数据仍然有限。本研究旨在揭示与左侧半球病变的中风患者在6个月随访期间功能恢复相关的预后变量。回顾性分析了167例左侧半球中风和183例右侧半球中风的数据。本研究的预后指标包括行走能力和功能恢复情况，通过改良Rankin量表（mRS）进行评估。为了获得独立的预测变量，本研究采用了参数多变量回归分析的逐步后退法。最终模型表明，偏瘫侧下肢的运动功能是行走能力和功能恢复最强的独立预测指标（风险比（RR）分别为2.41，95%置信区间：1.61 - 3.60，P < 0.001；RR为1.83，95%置信区间：1.03 - 3.26，P = 0.04）。因此，功能侧化似乎并未起作用。了解与恢复相关的可预测变量可以指导康复团队为中风患者确定优先事项并制定适当的治疗方案。
