Department of Rehabilitation Medicine, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Department of Rehabilitation Medicine, VU University Medical Center, De Boelelaan, 1117, 1081 HV, Amsterdam, The Netherlands.
J Neuroeng Rehabil. 2021 Mar 19;18(1):51. doi: 10.1186/s12984-021-00847-x.
It is unclear how arm use in daily life changes after stroke since studies investigating the change in arm use poststroke are scarce. The aim of this study was to investigate the change in arm use during the first six months poststroke. Secondary aim was to compare arm use changes between arm recovery clusters.
Arm use was measured during week 3, 12, and 26 poststroke with accelerometers on the wrists and the nonaffected leg. Outcomes were the amount of affected and nonaffected arm use during sitting and standing per day and per sit/stand hour, and the daily ratio between arms. Arm function was measured with the Fugl-Meyer Upper Extremity Scale to identify recovery clusters (poor/moderate/excellent). Generalized estimating equations compared arm use outcomes between time points and between recovery clusters.
Thirty-three stroke patients participated. Affected arm use per day increased between week 3 and 12 (30 %; p = 0.04) and it increased per sit/stand hour between week 3-12 (31 %; p < 0.001) and between week 3 and 26 (48 %; p = 0.02). Nonaffected arm use per day decreased between week 3 and 12 (13 %; p < 0.001) and between week 3 and 26 (22 %; p < 0.001) and it decreased per sit/stand hour between week 3 and 26 (18 %; p = 0.003). The daily ratio increased between week 3 and 12 (43 %; p < 0.001) and between week 3 and 26 (95 %; p < 0.001). Changes in arm use did not differ significantly between recovery clusters (p = 0.11-0.62). Affected arm use was higher in the excellent recovery cluster (p < 0.001).
Affected arm use and the ratio between arms increase during the first 26 weeks poststroke especially in patients with excellent arm recovery.
由于研究脑卒中后手臂使用变化的研究很少，因此尚不清楚日常生活中的手臂使用情况在脑卒中后如何变化。本研究旨在调查脑卒中后前 6 个月手臂使用的变化。次要目的是比较手臂恢复集群之间的手臂使用变化。
使用手腕和非受累腿上的加速度计在脑卒中后第 3、12 和 26 周测量手臂使用情况。结果是每天和每坐/站小时内受累和未受累手臂的使用量，以及手臂的每日比率。使用 Fugl-Meyer 上肢量表测量手臂功能，以确定恢复集群（差/中/优）。使用广义估计方程比较了不同时间点和不同恢复集群之间的手臂使用结果。
33 名脑卒中患者参与了研究。受累手臂的日使用量在第 3 周至 12 周之间增加（30%；p=0.04），在第 3 周至 12 周和第 3 周至 26 周之间每坐/站小时增加（31%；p<0.001 和 48%；p=0.02）。非受累手臂的日使用量在第 3 周至 12 周和第 3 周至 26 周之间减少（13%；p<0.001 和 22%；p<0.001），每坐/站小时减少（18%；p=0.003）。每日比率在第 3 周至 12 周和第 3 周至 26 周之间增加（43%；p<0.001 和 95%；p<0.001）。手臂使用的变化在恢复集群之间没有显著差异（p=0.11-0.62）。在优秀恢复集群中，受累手臂的使用频率更高（p<0.001）。
在脑卒中后前 26 周内，受累手臂的使用频率和手臂之间的比率增加，特别是在手臂恢复良好的患者中。
