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周围神经损伤后患者的预后取决于双手的灵巧度和患手的使用情况。

Patient Outcomes After Peripheral Nerve Injury Depend on Bimanual Dexterity and Preserved Use of the Affected Hand.

机构信息

Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.

Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA.

出版信息

Neurorehabil Neural Repair. 2024 Feb;38(2):134-147. doi: 10.1177/15459683241227222. Epub 2024 Jan 25.


DOI:10.1177/15459683241227222
PMID:38268466
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10922924/
Abstract

BACKGROUND: Little is known about how peripheral nerve injury affects human performance, behavior, and life. Hand use choices are important for rehabilitation after unilateral impairment, but rarely measured, and are not changed by the normal course of rehabilitation and daily life. OBJECTIVE: To identify the relationship between hand use (L/R choices), motor performance, and patient-centered outcomes. METHODS: Participants (n = 48) with unilateral peripheral nerve injury were assessed for hand use via Block Building Task, Motor Activity Log, and Edinburgh Handedness Inventory; dexterity (separately for each hand) via Nine-Hole Peg Test, Jebsen Taylor Hand Function Test, and a precision drawing task; patient-centered outcomes via surveys of disability, activity participation, and health-related quality of life; and injury-related factors including injury cause and affected nerve. Factor Analysis of Mixed Data was used to explore relationships between these variables. The data were analyzed under 2 approaches: comparing dominant hand (DH) versus non-dominant hand (NH), or affected versus unaffected hand. RESULTS: The data were best explained by 5 dimensions. Good patient outcomes were associated with NH performance, DH performance (separately and secondarily to NH performance), and preserved function and use of the affected hand; whereas poor patient outcomes were associated with preserved but unused function of the affected hand. CONCLUSION: After unilateral peripheral nerve injury, hand function, hand usage, and patient life arise from a complex interaction of many factors. To optimize rehabilitation after unilateral impairment, new rehabilitation methods are needed to promote performance and use with the NH, as well as the injured hand.

摘要

背景:关于周围神经损伤如何影响人类的表现、行为和生活,我们知之甚少。手的使用选择在手单侧受损后的康复中非常重要,但很少被测量,而且不会因正常康复过程和日常生活而改变。 目的:确定手的使用(左/右手选择)、运动表现和以患者为中心的结果之间的关系。 方法:评估了 48 名单侧周围神经损伤的参与者对手的使用(通过积木搭建任务、运动活动日志和爱丁堡手性量表进行评估);手部灵巧度(分别评估每只手)通过九孔钉测试、Jebsen Taylor 手功能测试和精确绘图任务进行评估;通过残疾、活动参与和健康相关生活质量的调查评估以患者为中心的结果;以及与损伤相关的因素,包括损伤原因和受累神经。混合数据因子分析用于探索这些变量之间的关系。数据根据 2 种方法进行分析:比较优势手(DH)与非优势手(NH),或患手与非患手。 结果:这些数据最好用 5 个维度来解释。良好的患者结局与 NH 表现、DH 表现(单独和次要地与 NH 表现相关)以及受影响手的功能和使用相关;而较差的患者结局与受影响手的功能保存但未使用相关。 结论:单侧周围神经损伤后,手的功能、手的使用和患者的生活是由许多因素复杂相互作用产生的。为了优化单侧损伤后的康复,需要新的康复方法来促进 NH 和受伤手的表现和使用。

相似文献

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[3]
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[6]
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[10]
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引用本文的文献

[1]
Block Building Task Identifies Distinct Groups of Left/Right-hand Choice Patterns After Unilateral Peripheral Nerve Injury.

J Vis Exp. 2025-3-21

本文引用的文献

[1]
Social Support Mediates the Association Between Abilities and Participation After Stroke.

OTJR (Thorofare N J). 2024-7

[2]
The Role of Physical Exercise and Rehabilitative Implications in the Process of Nerve Repair in Peripheral Neuropathies: A Systematic Review.

Diagnostics (Basel). 2023-1-18

[3]
Sensory nerve regeneration and reinnervation in muscle following peripheral nerve injury.

Muscle Nerve. 2022-10

[4]
Diabetic neuropathy is a generalized phenomenon with impact on hand functional performance and quality of life.

Eur J Neurol. 2022-10

[5]
Development and Initial Testing of the Electronic Activity Card Sort (ACS3) Among Community-Dwelling Adults.

Am J Occup Ther. 2022-5-1

[6]
Relationship Between Sensibility Tests and Functional Outcomes in Patients With Traumatic Upper Limb Nerve Injuries: A Systematic Review.

Arch Rehabil Res Clin Transl. 2021-9-20

[7]
Failure to Compensate: Patients With Nerve Injury Use Their Injured Dominant Hand, Even When Their Nondominant Is More Dexterous.

Arch Phys Med Rehabil. 2022-5

[8]
Interhemispheric Parietal-Frontal Connectivity Predicts the Ability to Acquire a Nondominant Hand Skill.

Brain Connect. 2021-5

[9]
A Systematic Review of Pharmacologic and Rehabilitative Treatment of Small Fiber Neuropathies.

Diagnostics (Basel). 2020-11-28

[10]
A Systematic Review of the Diagnostic Methods of Small Fiber Neuropathies in Rehabilitation.

Diagnostics (Basel). 2020-8-20

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