1 McGill University and Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.
2 Mahidol University, Nakhon Pathom, Thailand.
Neurorehabil Neural Repair. 2019 Jun;33(6):432-441. doi: 10.1177/1545968319847969. Epub 2019 May 10.
. Understanding the relationship between movement quality (impairment) and performance (activity) in poststroke patients is important for rehabilitation intervention studies. This has led to an interest in kinematic characterization of upper limb motor impairment. Since instrumented motion analysis is not readily clinically available, observational kinematics may be a viable alternative. . To determine if upper limb movement quality during a reach-to-grasp task identified by observation could be used to describe the relationship between motor impairments and the time to perform functional tasks. . Cross-sectional, secondary analysis of baseline data from 141 participants with stroke, age 18 to 85 years, who participated in a multicenter randomized controlled trial. Clinical assessment of movement quality using the Reaching Performance Scale for Stroke (RPSS-Close and Far targets) and of performance (activity) from the Wolf Motor Function Test (WMFT-7 items) was assessed. The degree to which RPSS component scores explained scores on WMFT items was determined by multivariable regression. . Clinically significant decreases (>2 seconds) in performance time for some of the more complex WMFT tasks involving prehension were predicted from RPSS-Close and Far target components. Trunk compensatory movements did not predict either increases or decreases in performance time for the WMFT tasks evaluated. Overall, the strength of the regression models was low. . In lieu of kinematic analysis, observational clinical movement analysis may be a valid and accessible method to determine relationships between motor impairment, compensations and upper limb function in poststroke patients. Specific relationships are unlikely to generalize to all tasks due to kinematic redundancy and task specificity.
. 了解脑卒中患者运动质量(损伤)与运动表现(活动)之间的关系,对于康复干预研究至关重要。这使得人们对上肢运动损伤的运动学特征产生了兴趣。由于仪器运动分析在临床上不易获得,观察性运动学可能是一种可行的替代方法。. 为了确定通过观察识别的上肢在伸手抓握任务中的运动质量是否可用于描述运动损伤与完成功能任务的时间之间的关系。. 这是一项 141 例脑卒中患者的横断面、二次数据分析研究,这些患者年龄在 18 至 85 岁之间,参加了一项多中心随机对照试验。使用脑卒中伸手表现量表(RPSS-Close 和 Far 目标)评估运动质量,使用 Wolf 运动功能测试(WMFT-7 项)评估运动表现(活动)。通过多元回归确定 RPSS 分量得分与 WMFT 项目得分之间的关系程度。. RPSS-Close 和 Far 目标分量可以预测一些涉及抓握的更复杂 WMFT 任务的表现时间出现临床显著下降(>2 秒)。评估的 WMFT 任务中,躯干代偿运动并未预测表现时间的增加或减少。总体而言,回归模型的强度较低。. 在没有运动分析的情况下,观察性临床运动分析可能是一种有效且可获取的方法,可用于确定脑卒中患者运动损伤、代偿和上肢功能之间的关系。由于运动学冗余和任务特异性,特定的关系不太可能推广到所有任务。