Bergfeldt Ulla, Strömberg Joakim, Ramström Therese, Kulbacka-Ortiz Katarzyna, Reinholdt Carina
Centre for Advanced Reconstruction of Extremities, University of Gothenburg, Gothenburg, Sweden.
J Hand Surg Eur Vol. 2020 Oct;45(8):807-812. doi: 10.1177/1753193420918743. Epub 2020 Apr 26.
The effects of spasticity-reducing surgery in the upper extremity were assessed in a prospective observational study of 30 consecutive patients with stroke ( = 13), incomplete spinal cord injury ( = 9), traumatic brain injury ( = 5), cerebral palsy ( = 2), and degenerative central nervous system disease ( = 1). Surgery, which included lengthening of tendons and release of muscles, was followed by early rehabilitation at three intensity levels depending on the patients' specific needs and conditions. At 12 months follow-up there were significant improvements in all outcome measures with the following mean values: spasticity decreased by 1.4 points (Modified Ashworth Scale, 0-5), visual analogue pain score by 1.3 points, and both Canadian Occupational Performance Measures increased (performance by 3.4 and satisfaction by 3.6), and most measures of joint position or mobility improved. Hand surgery combined with early and comprehensive rehabilitation improves function, activity and patients' satisfaction in patients with disabling spasticity with improvement lasting for at least 1 year. II.
在一项前瞻性观察研究中，对30例连续性患者进行了上肢痉挛缓解手术效果评估，这些患者分别患有中风（n = 13）、不完全性脊髓损伤（n = 9）、创伤性脑损伤（n = 5）、脑瘫（n = 2）和退行性中枢神经系统疾病（n = 1）。手术包括肌腱延长和肌肉松解，术后根据患者的具体需求和情况，分三个强度级别进行早期康复治疗。在12个月的随访中，所有结局指标均有显著改善，具体均值如下：痉挛程度（改良Ashworth量表，0 - 5级）降低1.4分，视觉模拟疼痛评分降低1.3分，加拿大职业表现测量的两项指标均有所提高（表现提高3.4分，满意度提高3.6分），大多数关节位置或活动度指标也有所改善。手部手术联合早期综合康复可改善功能、活动能力及患者满意度，对于致残性痉挛患者，改善效果至少可持续1年。II.
