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哪些临床和社会人口统计学因素与卒中后一年的自我感知手动能力相关?

Which clinical and sociodemographic determinants are associated with self-perceived manual ability at one year after stroke?

机构信息

Department of Health Sciences, Physiotherapy Research Group, Lund University, Lund, Sweden.

Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.

出版信息

Disabil Rehabil. 2020 Aug;42(16):2279-2286. doi: 10.1080/09638288.2018.1557265. Epub 2019 Jan 27.

Abstract

To evaluate the impact of multiple potential sociodemographic and clinical stroke-related determinants on self-perceived manual ability in an unselected sample of individuals 12 months after first-ever stroke. A cross-sectional sample of 68 participants (mean age 66) with UE impairments were followed up at 12 months post stroke. Stroke severity at onset was moderate for the majority. Manual ability was assessed by the patient-reported outcome measure ABILHAND Questionnaire. Determinants included in the multivariate regression analysis were age, gender, living situation, vocational situation, affected hand, stroke severity at onset and UE disability (motor function, sensory function, joint motion, pain, grip strength, spasticity and activity capacity) at 12 months post stroke. The strongest associated determinants with self-perceived manual ability were UE motor function and UE activity capacity at 12 months post-stroke. UE motor function together with age and grip strength explained 65% of the variance in one final multivariate model. UE activity capacity and grip strength explained 62% of the variance in a second final model. In order to understand self-perceived difficulties in manual ability in daily activities in persons with stroke, assessments of UE motor function and activity capacity are recommended.Implications for rehabilitationThe ultimate goal of the upper extremity rehabilitation after stroke is to regain ability to use the UE in daily activities that are important to the individual in his or her own environment.This requires a good understanding of factors that are associated with self-perceived manual ability in order to tailor effective rehabilitation interventions.Upper extremity motor function and activity capacity are the strongest determinants associated with self-perceived manual ability one year after stroke.These factors are recommended to be included in the assessment battery in stroke to fully understand the disability in daily life.

摘要

为了评估多种潜在的社会人口学和与中风相关的临床决定因素对首发中风后 12 个月内个体自我感知手部能力的影响,我们在一个未选择的个体样本中进行了研究。该研究纳入了 68 名(平均年龄 66 岁)上肢功能受损的患者作为研究对象,在中风后 12 个月进行随访。大多数患者的中风发病时严重程度为中度。使用患者报告的结局测量 ABILHAND 问卷评估手部能力。多变量回归分析中纳入的决定因素包括年龄、性别、居住情况、职业情况、受累手、中风发病时的严重程度以及中风后 12 个月时的上肢功能障碍(运动功能、感觉功能、关节运动、疼痛、握力、痉挛和活动能力)。与自我感知手部能力最相关的决定因素是中风后 12 个月时的上肢运动功能和上肢活动能力。上肢运动功能与年龄和握力一起解释了最终多变量模型中 65%的变异性。上肢活动能力和握力解释了第二个最终模型中 62%的变异性。为了理解中风患者日常活动中自我感知的手部能力困难,建议评估上肢运动功能和活动能力。

康复意义

中风后上肢康复的最终目标是恢复个体在其自身环境中对个人重要的日常活动中使用上肢的能力。

这需要很好地理解与自我感知手部能力相关的因素,以便制定有效的康复干预措施。

上肢运动功能和活动能力是与中风后 1 年自我感知手部能力最相关的决定因素。

这些因素建议纳入中风评估组合中,以全面了解日常生活中的残疾情况。

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