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一项关于脑卒中后肩痛患者上肢功能、睡眠质量和功能独立性的调查:一项横断面研究。

An investigation of upper extremity function, sleep quality, and functional independence in patients with poststroke shoulder pain: a cross-sectional study.

机构信息

Faculty of Health Science, Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University, Çubuk/Ankara, Turkey.

Institute of Health Sciences, Ankara Yıldırım Beyazıt University, Etlik/Ankara, Turkey.

出版信息

Physiother Theory Pract. 2024 Nov;40(11):2472-2479. doi: 10.1080/09593985.2023.2253313. Epub 2023 Aug 31.

Abstract

BACKGROUND

Poststroke shoulder pain (PSSP) is a common poststroke complication. Even though it is a common phenomenon, it is unclear how it impacts the patient's life.

OBJECTIVE

To investigate the differences in upper extremity function, sleep quality, and functional independence between patients with and without PSSP.

METHODS

This cross-sectional study included 63 participants with stroke (32 patients with PSSP and 31 patients without PSSP). Shoulder pain was evaluated with a Visual Analog Scale and the participants were divided into two groups as those with and without PSSP. The upper extremity function was assessed with the Disabilities of the Arm, Shoulder, and Hand Questionnaire, the Arm Motor Ability Test, and the Nine Hole Peg Test. Sleep quality was assessed with Pittsburgh Sleep Quality Index and the functional independence was assessed with the Functional Independence Measure. All data were analyzed using the program IBM SPSS Statistics 22.0. The Mann-Whitney U test was used to compare the non-normally distributed parameters, and the Chi-square test was used to compare the ordinal variables. The Spearman correlation test was used for the relationship and a linear regression test was used for regression.

RESULTS

Upper extremity function decreased ( < .05), only the sleep disturbance sub-parameter of sleep quality increased ( = .01), and functional independence increased in patients with PSSP ( < .001). There was a moderate relationship between pain and upper extremity function and a fair relationship between pain and sleep quality (use of sleep medications, daytime dysfunction sub-parameters) ( < .05).

CONCLUSIONS

PSSP impairs upper extremity functions, which play an important role in activities of daily living, and reduces functional independence. These results suggest that it is important to evaluate shoulder pain and examine the factors affecting pain in the rehabilitation of patients with stroke.

摘要

背景

脑卒中后肩痛(PSSP)是一种常见的脑卒中后并发症。尽管这是一种常见现象,但尚不清楚它如何影响患者的生活。

目的

调查有和无 PSSP 的脑卒中患者上肢功能、睡眠质量和功能独立性的差异。

方法

本横断面研究纳入 63 例脑卒中患者(PSSP 患者 32 例,无 PSSP 患者 31 例)。采用视觉模拟评分法评估肩部疼痛,并将患者分为有和无 PSSP 两组。采用上肢功能障碍问卷、上肢运动能力测试和九孔插钉测试评估上肢功能。采用匹兹堡睡眠质量指数评估睡眠质量,采用功能独立性量表评估功能独立性。所有数据均采用 IBM SPSS Statistics 22.0 程序进行分析。采用 Mann-Whitney U 检验比较非正态分布参数,采用卡方检验比较有序变量。采用 Spearman 相关检验分析相关性,采用线性回归检验进行回归。

结果

PSSP 患者上肢功能下降( < .05),仅睡眠质量的睡眠障碍亚参数增加( = .01),功能独立性增加( < .001)。疼痛与上肢功能之间存在中度关系,与睡眠质量之间存在中度关系(包括使用睡眠药物、日间功能障碍亚参数)( < .05)。

结论

PSSP 会损害上肢功能,而上肢功能对日常生活活动非常重要,并且会降低功能独立性。这些结果表明,在脑卒中患者的康复中,评估肩部疼痛并检查影响疼痛的因素非常重要。

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