脑卒中后疲劳与运动和认知表现相关：二次分析。
Poststroke Fatigue Is Related to Motor and Cognitive Performance: A Secondary Analysis.
机构信息
School of Physical Therapy, Texas Woman's University, Dallas (H.-T.G.); and Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia (J.C.S.).
出版信息
J Neurol Phys Ther. 2019 Oct;43(4):233-239. doi: 10.1097/NPT.0000000000000290.
BACKGROUND AND PURPOSE
Poststroke fatigue (PSF) is a common debilitating and persistent symptom after stroke. The relationship between PSF and motor and cognitive function remains inconclusive partly due to lack of control for effects of depression and use of insensitive measures. We examined the relationship between PSF and motor and cognitive performance using a comprehensive set of behavioral measures and excluding individuals with depression.
METHODS
Fifty-three individuals poststroke (16 female) were included (median age: 63 years, median months poststroke: 20 months). Poststroke fatigue was quantified using the Fatigue Severity Scale (FSS) and cognitive performance was measured with the Montreal Cognitive Assessment, simple and choice reaction time (SRT and CRT) tasks. Lower extremity motor performance included Fugl-Meyer Motor Assessment, 5 times sit-to-stand test (5 × STS), Berg Balance Scale, Functional Ambulation Category, and gait speed. Upper extremity motor performance was indexed with Fugl-Meyer, grip strength, and Box and Block test. Spearman correlation and stepwise linear regression analyses were performed to examine relationships.
RESULTS
Two motor performance measures, Berg Balance Scale and Functional Ambulation Category, were significantly correlated with FSS (ρ = -0.31 and -0.27, respectively) while all cognitive measures were significantly correlated with FSS (ρ = -0.28 for Montreal Cognitive Assessment, 0.29 for SRT, and 0.29 for CRT). Regression analysis showed that Berg Balance Scale was the only significant determinant for FSS (R = 0.11).
DISCUSSION AND CONCLUSIONS
Functional gait, balance, and cognitive performance are associated with PSF. Fatigue should be considered when planning and delivering interventions for individuals with stroke. Future studies are needed to explore the potential efficacy of balance and cognitive training in PSF management.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A287).
背景与目的
卒中后疲劳（PSF）是卒中后常见的致残性和持续性症状。PSF 与运动和认知功能之间的关系尚无定论，部分原因是缺乏对抑郁影响的控制和使用不敏感的测量方法。我们使用一系列全面的行为测量方法并排除抑郁患者，来检查 PSF 与运动和认知表现之间的关系。
方法
共纳入 53 例卒中后患者（16 例女性；中位年龄：63 岁；中位卒中后月数：20 个月）。使用疲劳严重度量表（FSS）来量化卒中后疲劳，使用蒙特利尔认知评估、简单和选择反应时（SRT 和 CRT）任务来测量认知表现。下肢运动表现包括 Fugl-Meyer 运动评估、5 次坐站测试（5×STS）、伯格平衡量表、功能性步行分类和步行速度。上肢运动表现用 Fugl-Meyer、握力和方块和木块测试来评估。采用 Spearman 相关和逐步线性回归分析来检验关系。
结果
两项运动表现测量，即伯格平衡量表和功能性步行分类，与 FSS 显著相关（ρ分别为-0.31 和-0.27），而所有认知测量均与 FSS 显著相关（蒙特利尔认知评估为-0.28，SRT 为 0.29，CRT 为 0.29）。回归分析显示，伯格平衡量表是 FSS 的唯一显著决定因素（R=0.11）。
讨论与结论
功能性步态、平衡和认知表现与 PSF 相关。在为卒中患者制定和实施干预措施时，应考虑疲劳。需要进一步的研究来探讨平衡和认知训练在 PSF 管理中的潜在效果。视频摘要可提供更多来自作者的见解（见视频，补充数字内容 1，可在以下网址获取：http://links.lww.com/JNPT/A287）。
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