Bushkov F A, Romanovskaya E V, Usanova E V, Razumov A N, Sichinava N V
Preodolenie Rehabilitation Center, Moscow, Russia.
Moscow Scientific and Practical Center for Medical Rehabilitation, Rehabilitation and Sports Medicine, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(1):47-52. doi: 10.17116/jnevro202112101147.
To study the recovery of the upper limb motor function and functional independence in patients with cervical spinal cord injury.
The study included 49 patients with subacute tetraplegia, mean age 33±14.8 years, 42 men and 7 women, admitted to the Preodolenie Rehabilitation Center. The follow-up was up to 2 years. The clinical and functional states were assessed after 3, 6, 12 and more than 12 months after spinal injury, using the ASIA neurological standard scale, the motor subscale of Functional Independence Scale (FIM) and short form of Van Lieshout Test (VLT). All patients received continuous rehabilitation courses that included physiotherapy, occupational therapy, social support, psychological rehabilitation.
Upper limb motor recovery occurred in the first 6 months after spinal cord injury at 5±3.9 points (ASIA), while in 49% patients motor level decreased by one segment of the spinal cord, in 8% patients completeness of spinal cord injury improved. The improvement of functional independence was found during the first 12 months: according to FIM, in the period of 3-6 months by 18±11.1 points, in the period of 6-12 months by 8±8.1 points; according to VLT in the period of 3-6 months by 19±14.4 points, in the period of 6-12 months by 5.6±6.02 points.
Upper limb motor recovery mostly occurs in the first 6 months while the functional independence improvement lasts during the first 12 months after a spinal cord injury.
研究颈脊髓损伤患者上肢运动功能及功能独立性的恢复情况。
该研究纳入了49例亚急性四肢瘫痪患者，平均年龄33±14.8岁，其中男性42例，女性7例，均入住Preodolenie康复中心。随访时间长达2年。在脊髓损伤后3、6、12个月及12个月以上，采用美国脊髓损伤协会（ASIA）神经学标准量表、功能独立性量表（FIM）运动亚量表及简化版范利绍特测试（VLT）评估患者的临床和功能状态。所有患者均接受了包括物理治疗、职业治疗、社会支持、心理康复在内的持续康复课程。
脊髓损伤后前6个月上肢运动功能恢复了5±3.9分（ASIA评分），49%的患者脊髓运动平面下降了一个节段，8%的患者脊髓损伤的完整性得到改善。在最初的12个月内发现功能独立性有所改善：根据FIM量表，在3 - 6个月期间提高了18±11.1分，在6 - 12个月期间提高了8±8.1分；根据VLT量表，在3 - 6个月期间提高了19±14.4分，在6 - 12个月期间提高了5.6±6.02分。
上肢运动功能的恢复大多发生在脊髓损伤后的前6个月，而功能独立性的改善则在损伤后的前12个月持续存在。
