From the Shirley Ryan AbilityLab, Chicago, Illinois (LM, CL, NS, MK, RLH); Northwestern University/Feinberg School of Medicine, Chicago, Illinois (LM, CL, NS, MK, RLH, SP); MedStar National Rehabilitation Network, Washington, DC (LM); University of Alabama at Birmingham, Birmingham, Alabama (CL); and University of Chicago, Chicago, Illinois (SP).
Am J Phys Med Rehabil. 2020 Apr;99(4):300-304. doi: 10.1097/PHM.0000000000001326.
The aim of this study was to determine whether the arm subscore of the Motricity Index 1 wk after stroke can predict recovery of upper limb function according to the Action Research Arm Test before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up.
This was a prospective cohort study of patients with acute ischemic stroke admitted to a single acute care hospital and affiliated inpatient rehabilitation facility between 2016 and 2018. Upper limb dexterity of the impaired limb was assessed using the arm subscore of the Motricity Index and Action Research Arm Test. Receiver operating characteristic curve analysis was used to determine optimal cutoffs of the initial arm subscore of the Motricity Index for a good functional outcome defined as Action Research Arm Test score of 45 or higher.
Ninety-five patients were evaluated at median 6, 26, and 98.5 days after stroke. The median (interquartile range) arm subscore of the Motricity Index at 1 wk was 77 (20.3-93). The median (interquartile range) Action Research Arm Test scores before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up were 33 (3.5-52) and 52 (34-55.8), respectively. The optimal arm subscore of the Motricity Index to predict Action Research Arm Test score of 45 or higher before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up were 71 and 58, respectively.
Early arm subscore of the Motricity Index at 1 wk predicts upper limb functional capacity before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up.
本研究旨在确定中风后 1 周时运动指数的手臂子评分是否可以根据住院康复机构出院前和 3 个月门诊随访时的动作研究手臂测试来预测上肢功能的恢复。
这是一项前瞻性队列研究，纳入了 2016 年至 2018 年间在一家急性护理医院和附属住院康复机构住院的急性缺血性中风患者。使用运动指数和动作研究手臂测试的手臂子评分评估患侧上肢的灵巧度。使用受试者工作特征曲线分析确定运动指数初始手臂子评分的最佳截断值，以预测良好的功能结局，定义为动作研究手臂测试评分 45 或更高。
共有 95 例患者在中风后中位 6、26 和 98.5 天进行了评估。运动指数 1 周时的手臂子评分中位数（四分位距）为 77（20.3-93）。住院康复机构出院前和 3 个月门诊随访时的动作研究手臂测试中位数（四分位距）分别为 33（3.5-52）和 52（34-55.8）。预测住院康复机构出院前和 3 个月门诊随访时动作研究手臂测试评分 45 或更高的最佳运动指数手臂子评分分别为 71 和 58。
中风后 1 周时运动指数的手臂子评分可预测住院康复机构出院前和 3 个月门诊随访时的上肢功能能力。
