Rehabilitation Department, Botucatu Medical School, Botucatu, Brazil.
Doctorate student in Physiopathology in Internal Medicine, Botucatu Medical School, Botucatu, Brazil.
Top Stroke Rehabil. 2021 Apr;28(3):181-189. doi: 10.1080/10749357.2020.1805244. Epub 2020 Aug 10.
Poor trunk control after stroke can impact recovery of global functional abilities. Therefore, the aim of this study was to evaluate whether clinical and functional data from stroke participants can be used to predict trunk control at 90 days.
This is a prospective study of 37 participants with stroke. The variables evaluated at hospital discharge were stroke severity (National Institute of Health Stroke Scale - NIHSS); functional capacity (modified Rankin scale - mRS); handgrip; and cognitive function. At 90 days, the variables evaluated were autonomy (Functional Independence Measure - FIM, Barthel Index); gait mobility (Tinetti mobility test -TMT); quality of life (European Quality of Life Scale - EuroQol-5D) and trunk control (trunk impairment scale - TIS). The participants were considered to have satisfactory (TIS³14) or non-satisfactory trunk control (TIS≤13), and the differences between them were assessed by chi-square test (categorical variables) and Mann-Whitney/unpaired t-test (continuous variables). A ROC curve was used to show cut-off value of clinical variables to predict trunk control.
The unsatisfactory trunk control group presented ahigher NIHSS at discharge (p=0.01), higher mRS at discharge (p=0.00), lower Barthel Index at 90 days (p=0.03), lower FIM at 90 days (p=0.01) and lower TMT at 90 days (p=0.00) than the satisfactory trunk control group. The best cut-off points for the NIHSS and mRS scores at discharge for predicting unsatisfactory trunk control are ≥6 and ≥3, respectively.
Greater NIHSS and mRS scores at hospital discharge increase the chance of unsatisfactory trunk control at 90 days after stroke.
中风后躯干控制能力差会影响整体功能的恢复。因此，本研究旨在评估中风患者的临床和功能数据是否可用于预测 90 天后的躯干控制能力。
这是一项对 37 名中风患者的前瞻性研究。在出院时评估的变量包括卒中严重程度（国立卫生研究院卒中量表 - NIHSS）；功能能力（改良 Rankin 量表 - mRS）；握力；和认知功能。90 天时，评估的变量包括自主能力（功能性独立测量量表 - FIM、巴氏量表）；步态移动性（Tinetti 移动测试 - TMT）；生活质量（欧洲生活质量量表 - EuroQol-5D）和躯干控制（躯干损伤量表 - TIS）。将患者分为躯干控制满意（TIS³14）或不满意（TIS≤13）两组，并通过卡方检验（分类变量）和曼-惠特尼/非配对 t 检验（连续变量）比较两组间的差异。ROC 曲线用于显示预测躯干控制的临床变量的截断值。
躯干控制不满意组在出院时 NIHSS 评分较高（p=0.01）、mRS 评分较高（p=0.00）、90 天时巴氏量表评分较低（p=0.03）、90 天时 FIM 评分较低（p=0.01）和 90 天时 TMT 评分较低（p=0.00）。出院时 NIHSS 和 mRS 评分预测躯干控制不满意的最佳截断点分别为≥6 和≥3。
出院时 NIHSS 和 mRS 评分较高，中风后 90 天躯干控制不满意的几率增加。
