Gschwind Claudia R, Yeomans Jayne L, Smith Belinda J
Department of Hand Surgery and Peripheral Nerve Surgery, Royal North Shore Hospital, Sydney, NSW, Australia.
Department of Physiotherapy, Royal North Shore Hospital, Sydney, NSW, Australia.
J Hand Surg Eur Vol. 2019 Nov;44(9):898-904. doi: 10.1177/1753193419866595. Epub 2019 Aug 12.
For individuals with acquired brain injury and severe upper limb spasticity, personal care is often difficult, time-consuming and painful. Previous studies on outcomes after surgery for upper limb spasticity have focused on functional gain, pain, hygiene and appearance. We operated on 38 non-communicative patients (45 limbs, 535 procedures) with severe spasticity and a non-functional upper limb(s). The surgical goals were to provide opening of the fingers and thumb, wrist stability and, if required, to release muscles around the elbow and shoulder. We used the Carer Burden Score as a relevant outcome measure. Preoperatively and 3 months postoperatively, the carer rated the degree of difficulty in cleaning the palm, cutting the fingernails, cleaning the axilla and dressing the upper body on a 5-point Likert scale. Surgery significantly improved the ease of care, which has implications not only for the patient but also for carers and associated health costs. IV.
对于患有后天性脑损伤和严重上肢痉挛的个体而言，个人护理往往困难、耗时且痛苦。先前关于上肢痉挛手术后结果的研究主要集中在功能改善、疼痛、卫生和外观方面。我们对38例无沟通能力的患者（45条肢体，进行了535次手术）进行了手术，这些患者存在严重痉挛且上肢无功能。手术目标是实现手指和拇指张开、手腕稳定，如有需要，还需松解肘部和肩部周围的肌肉。我们使用护理负担评分作为相关的结果指标。在术前和术后3个月，护理人员按照5级李克特量表对清洁手掌、修剪指甲、清洁腋窝和为上身穿衣的困难程度进行评分。手术显著提高了护理的便利性，这不仅对患者有影响，对护理人员和相关医疗成本也有影响。 四、
