Rafsten Lena, Meirelles Christiane, Danielsson Anna, Sunnerhagen Katharina S
Department of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.
Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
Front Neurol. 2019 Aug 21;10:912. doi: 10.3389/fneur.2019.00912. eCollection 2019.
Impaired postural balance is a common symptom after stroke and a common cause of falling. Most common daily tasks use arm and hand movements. Impairment in an upper extremity is a common stroke symptom, affecting 50-80% in the acute phase after stroke, and 40-50% in the sub-acute phase. The impact of leg function on postural balance has been investigated in several studies, but few have stressed the importance of arm function on postural balance. To explore whether there is any association between arm function and postural balance after stroke. A cross sectional study where 121 adults (mean age: 70 ± 12.3 years, 72 men) from two different data sources, Gothenburg Very Early Supported Discharge (GOTVED), and a study by Carvalho et al. were merged. Time for assessments ranged from 1 to 13 years when the patients were in the chronic phase. The dependent variables were Berg Balance scale (BBS) and Time Up and Go (TUG) both dichotomized to "impaired postural balance" and "not impaired postural balance." As independent variables, the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scale was used. The FMA-UE was presented with the total score. The motor function in the arm affected after stroke onset correlated with postural balance both measured with the BBS (0.321, < 0.001 and the TUG (-0.315, = 0.001. Having impaired motor function in the arm was significantly associated with impaired postural balance assessed with the BBS with OR = 0.879 (CI 0.826-0.934, < 0.001). Regression analysis with the TUG showed the same result, OR = 0.868 (CI 0.813-0.927, < 0.001) for FM-UE. The motor function of the affected arm was significantly associated with impaired postural balance post stroke, as assessed by BBS or TUG. It could be of clinical importance to be aware of the fact that not only lower extremity impairment, but also arm function can have an impact on postural balance in a late stage after stroke. VGFOUGSB-669501.
姿势平衡受损是中风后的常见症状，也是跌倒的常见原因。大多数日常任务都涉及手臂和手部动作。上肢功能受损是常见的中风症状，在中风急性期影响50 - 80%的患者，在亚急性期影响40 - 50%的患者。多项研究调查了腿部功能对姿势平衡的影响，但很少有研究强调手臂功能对姿势平衡的重要性。为了探讨中风后手臂功能与姿势平衡之间是否存在关联。一项横断面研究，将来自两个不同数据源（哥德堡早期支持出院计划（GOTVED）以及卡瓦略等人的一项研究）的121名成年人（平均年龄：70 ± 12.3岁，72名男性）的数据合并。患者处于慢性期时，评估时间范围为1至13年。因变量为伯格平衡量表（BBS）和起立行走测试（TUG），二者均分为“姿势平衡受损”和“姿势平衡未受损”。作为自变量，使用了 Fugl - Meyer 上肢评估量表（FMA - UE）。FMA - UE 以总分形式呈现。中风发作后受影响手臂的运动功能与用 BBS 测量的姿势平衡相关（0.321，< 0.001）以及与 TUG 相关（-0.315，= 0.001）。手臂运动功能受损与用 BBS 评估的姿势平衡受损显著相关，OR = 0.879（CI 0.826 - 0.934，< 0.001）。用 TUG 进行回归分析显示了相同结果，FMA - UE 的 OR = 0.868（CI 0.813 - 0.927，< 0.001）。如通过 BBS 或 TUG 评估，中风后受影响手臂的运动功能与姿势平衡受损显著相关。意识到不仅下肢损伤，而且手臂功能在中风后期也会对姿势平衡产生影响这一事实可能具有临床重要性。VGFOUGSB - 669501。
