Salvalaggio Silvia, Boccuni Leonardo, Turolla Andrea
Laboratory of Computational Neuroimaging, IRCCS San Camillo Hospital, Venezia, Italy.
Padova Neuroscience Center, Università Degli Studi Di Padova, Via Orus 2/B, 35131, Padova, Italy.
Arch Physiother. 2023 Jun 19;13(1):13. doi: 10.1186/s40945-023-00167-4.
In neurorehabilitation clinical practice, assessment is usually more oriented to evaluate patient's present status, than to plan interventions according to predicted outcomes. Therefore, we conducted an extensive review of current prognostic models available in the literature for recovery prediction of many functions and constructs, after stroke. We reported results in the form of a practical guide for clinicians, with the aim of promoting the culture of early clinical assessment for patient stratification, according to expected outcome. To define a roadmap for clinicians, a stepwise sequence of five actions has been developed, from collecting information of past medical history to the adoption of validated prediction tools. Furthermore, a clinically-oriented organization of available prediction tools for recovery after stroke have been proposed for motor, language, physiological and independency functions. Finally, biomarkers and online resources with prognostic value have been reviewed, to give the most updated state of the art on prediction tools after stroke.
Clinical assessment should be directed both towards the objective evaluation of the present health status, and to the prediction of expected recovery. The use of specific outcome measures with predictive value is recommended to help clinicians with the definition of sound therapeutic goals.
在神经康复临床实践中，评估通常更侧重于评估患者的当前状况，而非根据预测结果来规划干预措施。因此，我们对文献中现有的用于预测卒中后多种功能和结构恢复情况的预后模型进行了广泛综述。我们以临床医生实用指南的形式报告结果，旨在促进根据预期结果对患者进行分层的早期临床评估文化。为临床医生制定路线图，我们制定了一个从收集既往病史信息到采用经过验证的预测工具的五步逐步序列。此外，针对运动、语言、生理和独立功能，我们提出了一种以临床为导向的卒中后恢复可用预测工具的组织方式。最后，我们对具有预后价值的生物标志物和在线资源进行了综述，以呈现卒中后预测工具的最新技术水平。
临床评估应既针对当前健康状况的客观评估，也针对预期恢复情况的预测。建议使用具有预测价值的特定结局指标，以帮助临床医生确定合理的治疗目标。
