Bondi Moshe, Kalsi-Ryan Sukhvinder, Delparte Jude J, Burns Anthony S
Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Spinal Cord. 2022 May;60(5):422-427. doi: 10.1038/s41393-022-00782-1. Epub 2022 Mar 10.
Post hoc analysis of prospective multi-national, multi-centre cohort study.
Determine whether cerebral dominance influences upper extremity recovery following cervical spinal cord injury (SCI).
A multi-national subset of the longitudinal GRASSP dataset (n = 127).
Secondary analysis of prospective, longitudinal multicenter study of individuals with cervical SCI (n = 73). Study participants were followed for up to 12 months after a cervical SCI, and the following outcome measures were serially assessed - the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) and the International Standards for the Neurological Classification of SCI (ISNCSCI), including upper extremity motor and sensory scores. Observed recovery and relative (percent) recovery were then determined for both the GRASSP and ISNCSCI, based on change from initial to last available assessment.
With the exception of prehension performance (quantitative grasping) following complete cervical SCI, there were no significant differences (p < 0.05) for observed and relative (percent) recovery, between the dominant and non-dominant upper extremities, as measured using GRASSP subtests, ISNCSCI motor scores and ISNCSCI sensory scores.
Despite well documented differences between the cerebral hemispheres, cerebral dominance appears to play a limited role in upper extremity recovery following acute cervical SCI.
对前瞻性多国多中心队列研究进行事后分析。
确定大脑优势是否会影响颈脊髓损伤(SCI)后上肢的恢复情况。
纵向GRASSP数据集的一个多国子集(n = 127)。
对颈脊髓损伤患者(n = 73)的前瞻性纵向多中心研究进行二次分析。研究参与者在颈脊髓损伤后随访长达12个月,并对以下结局指标进行连续评估——力量、感觉和抓握能力的分级重新评估(GRASSP)以及脊髓损伤神经学分类国际标准(ISNCSCI),包括上肢运动和感觉评分。然后根据从初始评估到最后一次可用评估的变化,确定GRASSP和ISNCSCI的观察到的恢复情况和相对(百分比)恢复情况。
除了完全性颈脊髓损伤后的抓握表现(定量抓握)外,使用GRASSP子测试、ISNCSCI运动评分和ISNCSCI感觉评分测量时,优势上肢和非优势上肢在观察到的恢复情况和相对(百分比)恢复情况方面没有显著差异(p < 0.05)。
尽管大脑半球之间的差异已有充分记录,但大脑优势在急性颈脊髓损伤后的上肢恢复中似乎作用有限。