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壳核出血后3个月独立行走的相关因素:一项观察性研究。

Factors associated with independent ambulation at 3 months after putaminal hemorrhage: an observational study.

作者信息

Ikeda Noriko, Sakurai Masaru, Yamada Emika, Gotoh Soichiro, Tanabe Nozomu, Hayashi Yasuhiko, Matsushita Isao

机构信息

Department of Rehabilitation, Kanazawa Medical University Hospital: 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan.

Department of Social and Environmental Medicine, Kanazawa Medical University, Japan.

出版信息

J Phys Ther Sci. 2024 Apr;36(4):167-174. doi: 10.1589/jpts.36.173. Epub 2024 Apr 1.

Abstract

[Purpose] This study was aimed at evaluating the clinical indicators for predicting ambulation at 3 months after putaminal hemorrhage. [Participants and Methods] The participants were 84 inpatients with putaminal hemorrhage. The patients' background characteristics and computed tomography findings at the time of the onset of putaminal hemorrhage were obtained from their medical records. Impaired consciousness, severity of hemiplegia, higher brain dysfunction, sensory impairment, activities of daily living, and ambulatory ability were evaluated. Logistic regression analysis was performed to identify factors associated with ambulation at 3 months, and receiver operating characteristic curve analysis was conducted to determine the predictive value of the identified factors and the optimal cut-off values. [Results] Ventricular rupture, severity of hemiplegia (determined using the 12-grade hemiplegia function test), and Functional Independence Measure cognitive score were found to be independent predictors of prognosis. Severity of hemiplegia was the strongest predictor of ambulation, with a sensitivity of 80.4% and specificity of 100% when the cut-off was set at grade 6 (the ability for coordinated movement of the extensor and flexor muscles of the hip joint). [Conclusion] The severity of hemiplegia, Functional Independence Measure cognitive score, and ventricular rupture were independently associated with ambulation in patients with putaminal hemorrhage. The ability of the hip joint movement is one of the most important factors in ambulation prognosis.

摘要

[目的] 本研究旨在评估预测壳核出血后3个月步行能力的临床指标。[参与者与方法] 参与者为84例壳核出血住院患者。从其病历中获取壳核出血发病时患者的背景特征和计算机断层扫描结果。评估意识障碍、偏瘫严重程度、高级脑功能障碍、感觉障碍、日常生活活动能力和步行能力。进行逻辑回归分析以确定与3个月步行能力相关的因素,并进行受试者工作特征曲线分析以确定所识别因素的预测价值和最佳临界值。[结果] 脑室破裂、偏瘫严重程度(使用12级偏瘫功能测试确定)和功能独立性测量认知评分被发现是预后的独立预测因素。偏瘫严重程度是步行能力最强的预测因素,当临界值设定为6级(髋关节伸肌和屈肌协调运动能力)时,敏感性为80.4%,特异性为100%。[结论] 偏瘫严重程度、功能独立性测量认知评分和脑室破裂与壳核出血患者的步行能力独立相关。髋关节运动能力是步行预后最重要的因素之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402b/10981957/0969bbba2b1a/jpts-36-167-g001.jpg

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