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中风康复后上肢恢复的临床预测因素:回顾性队列研究

Clinical Predictors for Upper Limb Recovery after Stroke Rehabilitation: Retrospective Cohort Study.

作者信息

Salvalaggio Silvia, Cacciante Luisa, Maistrello Lorenza, Turolla Andrea

机构信息

Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy.

Padova Neuroscience Center, Università degli Studi di Padova, Via Orus 2/B, 35131 Padova, Italy.

出版信息

Healthcare (Basel). 2023 Jan 23;11(3):335. doi: 10.3390/healthcare11030335.

Abstract

After stroke, recovery of upper limb (UL) motor function is enhanced by a high dose of rehabilitation and is supposed to be supported by attentive functions. However, their mutual influence during rehabilitation is not well known yet. The aim of this retrospective observational cohort study was to investigate the association between rehabilitation dose and motor and cognitive functions, during UL motor recovery. Inpatients with first unilateral stroke, without time restrictions from onset, and undergoing at least 15 h of rehabilitation were enrolled. Data on dose and modalities of rehabilitation received, together with motor and cognitive outcomes before and after therapy, were collected. Fugl-Meyer values for the Upper Extremity were the primary outcome measure. Logistic regression models were used to detect any associations between UL motor improvement and motor and cognitive-linguistic features at acceptance, regarding dose of rehabilitation received. Thirty-five patients were enrolled and received 80.57 ± 30.1 h of rehabilitation on average. Manual dexterity, level of independence and UL motor function improved after rehabilitation, with no influence of attentive functions on motor recovery. The total amount of rehabilitation delivered was the strongest factor ( = 0.031) influencing the recovery of UL motor function after stroke, whereas cognitive-linguistic characteristics were not found to influence UL motor gains.

摘要

中风后,高剂量康复训练可增强上肢(UL)运动功能的恢复,且推测注意力功能对此有支持作用。然而,它们在康复过程中的相互影响尚不清楚。这项回顾性观察队列研究的目的是调查在UL运动功能恢复期间康复剂量与运动和认知功能之间的关联。纳入首次发生单侧中风的住院患者,发病时间无限制,且接受至少15小时的康复训练。收集所接受康复训练的剂量和方式的数据,以及治疗前后的运动和认知结果。上肢的Fugl-Meyer值是主要结局指标。使用逻辑回归模型来检测在接受康复训练时,UL运动功能改善与运动及认知语言特征之间的任何关联,这些关联涉及所接受的康复剂量。共纳入35例患者,平均接受了80.57±30.1小时的康复训练。康复训练后,手部灵活性、独立程度和UL运动功能均有所改善,注意力功能对运动恢复没有影响。中风后,所提供的康复训练总量是影响UL运动功能恢复的最强因素(P = 0.031),而未发现认知语言特征会影响UL运动功能的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07b8/9913979/b5fab67eee73/healthcare-11-00335-g001.jpg

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