Faculty of Health Sciences, Discipline of Physiotherapy, University of Sydney, Cumberland Campus C42, Sydney, Australia.
Faculty of Health Sciences, Discipline of Physiotherapy, University of Canberra, Canberra, Australia.
Physiother Theory Pract. 2020 Jan;36(1):196-202. doi: 10.1080/09593985.2018.1482584. Epub 2018 Jun 11.
: To investigate, in patients after stroke with a very weak upper limb, the profile of recovery for upper limb activity over the first 12 weeks, and whether early secondary impairments predict later upper limb activity. : Forty patients within 2 weeks of stroke with a very weak upper limb (<4/6 Item 6 of Motor Assessment Scale) were observed longitudinally. Upper limb activity (Items 6, 7, and 8 of Motor Assessment Scale), shoulder subluxation (vertical distance), shoulder pain (visual analogue scale), and upper limb range of motion were measured at 2, 6, and 12 weeks poststroke. : By Week 12, upper limb activity was 1.0/18 (IQR 3.0). Shoulder subluxation was 42 mm (SD 8), 7 mm > the intact side at 2 weeks. Pain at rest was 0.1/10 (IQR 1.1), and pain during movement was 2.6/10 (IQR 4.5). Passive shoulder external rotation was 23° (SD 34), 30% of the intact side at 2 weeks. Shoulder pain during movement at 2 weeks predicted shoulder pain during movement at 6 and 12 weeks after stroke ( = 0.05). : Most patients with a disabled upper limb after stroke have little recovery of activity in the first 12 weeks. Shoulder pain on movement at 2 weeks should be flagged as a predictor of future pain.
：在患有非常虚弱上肢的中风后患者中，研究上肢活动在最初 12 周内的恢复情况，以及早期继发性损伤是否预测以后的上肢活动。：在中风后 2 周内有非常虚弱上肢（<4/6 运动评估量表项目 6）的 40 名患者进行了纵向观察。在中风后 2、6 和 12 周时测量上肢活动（运动评估量表项目 6、7 和 8）、肩部半脱位（垂直距离）、肩部疼痛（视觉模拟评分）和上肢活动范围。：到第 12 周时，上肢活动度为 1.0/18（IQR 3.0）。肩部半脱位为 42mm（SD 8），2 周时比健侧高 7mm。静息时疼痛为 0.1/10（IQR 1.1），运动时疼痛为 2.6/10（IQR 4.5）。被动肩外旋为 23°（SD 34），2 周时为健侧的 30%。2 周时运动时的肩部疼痛预测了中风后 6 和 12 周时的运动时肩部疼痛（=0.05）。：大多数中风后上肢功能障碍的患者在最初 12 周内活动恢复很少。2 周时运动时的肩部疼痛应被标记为未来疼痛的预测指标。
