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马来西亚大学医学中心慢性四肢瘫痪患者的上肢功能状态

Upper Extremity Functional Status in Patients with Chronic Tetraplegia in Universiti Malaya Medical Centre.

作者信息

Sundrasegaran Punithamalar, Engkasan Julia Patrick

机构信息

Department of Rehabilitation Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.

出版信息

Malays J Med Sci. 2023 Dec;30(6):79-90. doi: 10.21315/mjms2023.30.6.9. Epub 2023 Dec 19.

Abstract

BACKGROUND

Persons with tetraplegia rank improved upper extremity (UE) function as the most important rehabilitation outcome because it allows them greater independence in activities of daily living (ADL). The aim of this study was to describe UE status in patients with tetraplegia using the International Spinal Cord Injury Upper Extremity Basic Data Set version 1.1 (ISCI-UE 1.1) and to determine differences in UE status between tetraplegic individuals with traumatic and non-traumatic SCIs.

METHODS

This cross-sectional study was conducted among patients with tetraplegia who attended the SCI rehabilitation clinic of a tertiary hospital from September 2021 to August 2022. Both upper limbs were assessed using ISCI-UE 1.1.

RESULTS

One hundred patients were included in this study, of whom 80 were men. The mean (SD) age of the patients was 54.30 (16.95) years old. In these patients, most SCIs (62%) were of traumatic origin. Two hundred UEs were evaluated, of which 109 showed good hand function (level 5) and 10 had the poorest hand function (level 1). Meanwhile, 130 UEs showed good shoulder function (level D) and 10 had the poorest shoulder function (level A). A statistically significant association with UE status (reach-and-grasp ability and shoulder function) was found in both the non-traumatic and traumatic SCI groups, with better hand and shoulder functions in the non-traumatic SCI group (right-hand, = 0.004 and left hand, = 0.001; right shoulder, < 0.001 and left shoulder, = 0.002).

CONCLUSION

ISCI-UE 1.1 is a feasible tool for documenting UE function in patients with tetraplegia. Compared with the individuals with traumatic SCI in this study, those with non-traumatic SCI demonstrated better upper extremity functionality.

摘要

背景

四肢瘫痪患者将上肢功能改善视为最重要的康复成果,因为这能让他们在日常生活活动(ADL)中获得更大的独立性。本研究的目的是使用国际脊髓损伤上肢基础数据集第1.1版(ISCI-UE 1.1)描述四肢瘫痪患者的上肢状况,并确定创伤性和非创伤性脊髓损伤的四肢瘫痪个体在上肢状况上的差异。

方法

本横断面研究于2021年9月至2022年8月在一家三级医院的脊髓损伤康复诊所对四肢瘫痪患者进行。使用ISCI-UE 1.1对双上肢进行评估。

结果

本研究纳入了100名患者,其中80名男性。患者的平均(标准差)年龄为54.30(16.95)岁。在这些患者中,大多数脊髓损伤(62%)为创伤性。评估了200条上肢,其中109条显示手部功能良好(5级),10条手部功能最差(1级)。同时,130条上肢显示肩部功能良好(D级),10条肩部功能最差(A级)。在非创伤性和创伤性脊髓损伤组中均发现与上肢状况(抓握能力和肩部功能)存在统计学显著关联,非创伤性脊髓损伤组的手部和肩部功能更好(右手P = 0.004,左手P = 0.001;右肩P < 0.001,左肩P = 0.002)。

结论

ISCI-UE 1.1是记录四肢瘫痪患者上肢功能的可行工具。与本研究中的创伤性脊髓损伤个体相比,非创伤性脊髓损伤个体的上肢功能更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cad/10793124/169d9c0ef92c/09mjms3006_oaf1.jpg

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