Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University , Utrecht, The Netherlands.
Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, and De Hoogstraat Rehabilitation , Utrecht, The Netherlands.
Top Stroke Rehabil. 2020 Oct;27(7):525-533. doi: 10.1080/10749357.2020.1738662. Epub 2020 Mar 9.
: Impairments in arm function are a common problem in stroke survivors and have a large impact on health-related quality of life (HRQoL). Little is known about the longitudinal relationship between recovery of upper limb strength and changes in HRQoL. : This study aimed to determine to what extent changes in HRQoL are related to changes in upper limb strength after discharge from inpatient rehabilitation. : 250 patients from an RCT were assessed at discharge from inpatient rehabilitation (baseline) and at 12 weeks post-discharge (follow-up). The Stroke Impact Scale was used to measure HRQoL, and the Motricity Index Arm was used to measure upper limb strength. Hierarchical regression analysis was performed to determine the predictive value of upper limb strength on HRQoL, relative to demographic and clinical characteristics. Regression analysis was used to determine the relation between upper limb strength improvement and HRQoL improvement. : Upper limb strength at baseline was a major predictor of HRQoL at follow-up, after accounting for demographic and clinical characteristics ( < .05). Improvement in HRQoL was positively related to improvement in upper limb strength ((1, 240) = 18.351, <.0005). : These findings highlight the importance of upper limb strength in HRQoL, as HRQoL is associated with improvement in upper limb strength recovery. Better monitoring of recovery and treatment of upper limb strength during the outpatient rehabilitation period and beyond, i.e. outside the typical time-window of recovery in the first 3 months post-stroke, might contribute to higher quality of life for stroke survivors.
手臂功能障碍是中风幸存者的常见问题，对健康相关生活质量（HRQoL）有很大影响。对于上肢力量恢复与 HRQoL 变化之间的纵向关系知之甚少。本研究旨在确定出院后上肢力量变化与 HRQoL 变化之间的关系。对来自 RCT 的 250 名患者在住院康复出院时（基线）和出院后 12 周（随访）进行评估。使用中风影响量表评估 HRQoL，使用运动指数手臂评估上肢力量。进行层次回归分析，以确定上肢力量相对于人口统计学和临床特征对 HRQoL 的预测价值。回归分析用于确定上肢力量改善与 HRQoL 改善之间的关系。基线时的上肢力量是随访时 HRQoL 的主要预测因素，考虑到人口统计学和临床特征（ < 0.05）。HRQoL 的改善与上肢力量的改善呈正相关（(1, 240) = 18.351, < 0.0005）。这些发现强调了上肢力量在 HRQoL 中的重要性，因为 HRQoL 与上肢力量恢复的改善有关。更好地监测上肢力量的恢复和治疗，包括在门诊康复期间以及出院后，即中风后 3 个月内的典型恢复时间窗之外，可能有助于提高中风幸存者的生活质量。
