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与卒中后失用症发展相关的临床因素:一项前瞻性研究。

Clinical factors associated with the development of nonuse learned after stroke: a prospective study.

机构信息

Department of rehabilitation Center, Botucatu Medical School , Botucatu , Brazil.

Department of Applied Physical Therapy, Federal University of Triângulo Mineiro , Uberaba , Brazil.

出版信息

Top Stroke Rehabil. 2019 Oct;26(7):511-517. doi: 10.1080/10749357.2019.1631605. Epub 2019 Jun 22.

DOI:10.1080/10749357.2019.1631605
PMID:31230583
Abstract

: Upper extremity impairment is present in most of people with stroke. The use of the affected upper extremity can be impacted not only by physical impairment but also by abehavioral phenomenon called learned nonuse. : The aim of this study was to evaluate which clinical factors in the acute phase are associated with the development of learned nonuse in the upper extremity after stroke. : This cohort study included 38 patients with ischemic stroke. Hospital discharge data were collected for clinical aspects, scales of severity, incapacity and autonomy, as well as for neuromuscular and sensory evaluations. At 90 days after hospital discharge, the score on the Motor Activity Log scale for detecting learned nonuse was obtained, and life quality was evaluated by the EuroQol. The individuals with and without learned nonuse were compared by attest for univariate analysis, and ageneralized linear model was employed to find possible predictors, which were considered significant p <0.05. : In the statistical model, age (p= .006), severity at discharge (p= .036), handgrip strength (p= .000), altered sensitivity (p= .011), incapacity at discharge (p= .009) and autonomy at discharge (p= .011) were found to be associated with learned nonuse. In relation to quality of life, mobility, personal care, usual activities, anxiety, depression and perception had lower mean values in the learned nonuse group. : Age, severity of stroke, incapacity and neuromuscular and sensory compromises are associated with upper extremity learned nonuse in stroke patients.

摘要

: 大多数脑卒中患者都存在上肢功能障碍。上肢的使用不仅会受到身体损伤的影响,还会受到一种称为习得性废用的行为现象的影响。: 本研究旨在评估急性期中哪些临床因素与脑卒中后上肢习得性废用的发展有关。: 这项队列研究纳入了 38 例缺血性脑卒中患者。收集了医院出院时的临床资料、严重程度评分、失能和自主能力,以及神经肌肉和感觉评估。在出院后 90 天,使用运动活动日志量表评估习得性废用,并用 EuroQol 评估生活质量。通过单变量分析比较有无习得性废用的个体,并采用广义线性模型寻找可能的预测因素,认为 p<0.05 具有统计学意义。: 在统计模型中,年龄(p=0.006)、出院时的严重程度(p=0.036)、握力(p=0.000)、感觉改变(p=0.011)、出院时的失能(p=0.009)和出院时的自主能力(p=0.011)与习得性废用相关。在生活质量方面,移动、个人护理、日常活动、焦虑、抑郁和感知方面,习得性废用组的平均值较低。: 年龄、脑卒中严重程度、失能以及神经肌肉和感觉受损与脑卒中患者上肢习得性废用有关。

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