Department of Neurorehabilitation of Pavia via Boezio Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia 27100, Italy.
Department of Neurorehabilitation, Casa di Cura Figlie di San Camillo, Cremona 26100, Italy.
Behav Neurol. 2020 Nov 17;2020:8216758. doi: 10.1155/2020/8216758. eCollection 2020.
Progressive increase of an aging population in Western countries will result in a growth of stroke prevalence. As many stroke survivors chronically show severe disability, increase in economic, social, and medical burden could be expected in the future. Objective and subjective measures of poststroke recovery are necessary to obtain predictive information, to improve the treatments, and to better allocate resources.
To explore a measure of the temporal dimension of poststroke recovery, to search for predictive association with multiple clinical variables, and to improve tailoring of poststroke treatments.
In this observational monocentric cohort study, 176 poststroke inpatients at their first cerebrovascular event were consecutively enrolled. A novel measure based on the time needed to reach the main milestones of motor recovery was proposed. Moreover, two commonly used outcome measures, a measure of global functioning (Functional Independence Measure (FIM™)) and a measure of neurological poststroke deficit (Fugl-Meyer scale), were collected for the investigations of possible predictors.
The patients showed a substantial increase in Fugl-Meyer and FIM scores during the rehabilitative treatment. The acquisition of three milestones was significantly associated with female sex (autonomous standing), length of stay and Fugl-Meyer initial score (autonomous walking), and Fugl-Meyer initial score (functional arm). These findings provided quantitative data on motor milestone reacquisition in a sample of poststroke patients. It also demonstrated the value of the Fugl-Meyer score in predicting the acquisition of two motor milestones, relevant for daily life activities.
Systematic recording of the timescale of poststroke recovery showed that motor milestone reacquisition happens, on average and when attainable, in less than 30 days in our sample of patients. The present study underscores the importance of the Fugl-Meyer score as a possible predictor for better improvement in reacquisition times of milestone functional recovery.
西方国家人口老龄化的逐渐增加将导致中风发病率的上升。由于许多中风幸存者长期存在严重的残疾，预计未来经济、社会和医疗负担将会增加。需要客观和主观的中风后恢复措施来获取预测信息，改善治疗方法，并更好地分配资源。
探索中风后恢复的时间维度的衡量标准，寻找与多个临床变量的预测关联，并改善中风后的治疗方法。
在这项观察性的单中心队列研究中，连续纳入了 176 名首次发生脑血管事件的中风住院患者。提出了一种基于达到运动恢复主要里程碑所需时间的新衡量标准。此外，还收集了两个常用的结局衡量标准，即全面功能衡量标准（功能性独立量表（FIM ™））和中风后神经功能缺损衡量标准（Fugl-Meyer 量表），以调查可能的预测因素。
患者在康复治疗期间 Fugl-Meyer 和 FIM 评分有了显著提高。获得三个里程碑与女性（自主站立）、住院时间和 Fugl-Meyer 初始评分（自主行走）以及 Fugl-Meyer 初始评分（功能性手臂）显著相关。这些发现为中风后患者样本中运动里程碑的重新获得提供了定量数据。它还证明了 Fugl-Meyer 评分在预测两个与日常生活活动相关的运动里程碑的获得方面的价值。
系统记录中风后恢复的时间尺度表明，在我们的患者样本中，平均而言，运动里程碑的重新获得可在不到 30 天的时间内实现。本研究强调了 Fugl-Meyer 评分作为可能的预测因素，对于改善里程碑功能恢复的重新获得时间具有重要意义。
