Department of Health Sciences, Lund University, Lund, Sweden.
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
BMC Neurol. 2020 May 12;20(1):181. doi: 10.1186/s12883-020-01754-9.
Recovery patterns of motor function and activity capacity of the upper extremity after stroke have been described, but less is known about longitudinal changes of perceived manual activity performance. The aim of this study was to investigate longitudinal changes of self-perceived manual ability at several timepoints from onset until 12 months post-stroke in a cohort of consecutively recruited individuals with mild, moderate and severe stroke.
The study included 106 participants from a non-selected cohort with first-ever mild, moderate or severe stroke and impaired upper extremity function (Stroke Arm Longitudinal Study at the University of Gothenburg, SALGOT). Self-perceived manual ability was assessed with the ABILHAND Questionnaire at 3 and 10 days, 4 weeks, 3, 6 and 12 months after stroke. Longitudinal change was assessed by linear mixed models (fixed and random effects) and adjusted models were built by adding effects of cofactors age, gender, stroke severity, living condition and affected hand.
Self-perceived manual ability increased over time the first year after stroke for the total group and the subgroups. The final adjusted model for the total group included fix-effects of time (expected mean change 0.24 logits per month) adjusted by age (- 0.06 per year) and stroke severity (- 0.19 per NIHSS-score). In addition to significant effect of time, the adjusted models for moderate stroke subgroup included fixed effect of age, and for mild and severe subgroups there was an interaction effect between time and age. Further analyses between time-points showed that no significant change of self-perceived manual ability was detected beyond 3 months post-stroke.
Self-perceived manual ability increased over time the first year after stroke, and this change was to some degree modulated by age and stroke severity at onset. Most of the improvements occurred early, predominantly within the first three months after stroke.
已经描述了中风后上肢运动功能和活动能力的恢复模式，但对手动活动表现的感知纵向变化知之甚少。本研究的目的是调查轻度、中度和重度中风患者连续招募的队列中，从发病到中风后 12 个月的几个时间点自我感知手部能力的纵向变化。
该研究包括来自哥德堡大学首次轻度、中度或重度中风和上肢功能受损的非选择性队列（哥德堡大学中风上肢纵向研究，SALGOT）的 106 名参与者。自我感知的手动能力使用 ABILHAND 问卷在中风后 3 天和 10 天、4 周、3、6 和 12 个月进行评估。通过线性混合模型（固定和随机效应）评估纵向变化，并通过添加协变量年龄、性别、中风严重程度、生活状况和受影响的手的影响来构建调整后的模型。
中风后第一年，总组和亚组的自我感知手动能力随时间增加。总组的最终调整模型包括时间的固定效应（每月预期平均变化 0.24 对数），通过年龄（每年减少 0.06）和 NIHSS 评分（每 NIHSS 评分减少 0.19）进行调整。除了时间的显著影响外，中度中风亚组的调整模型还包括年龄的固定效应，而轻度和重度亚组的时间和年龄之间存在交互效应。进一步的时间点之间的分析表明，中风后 3 个月后，自我感知手动能力没有明显变化。
中风后第一年，自我感知的手动能力随时间增加，这种变化在某种程度上受到发病时年龄和中风严重程度的调节。大多数改善发生在早期，主要发生在中风后三个月内。
