Dudgeon B J, DeLisa J A, Miller R M
Arch Phys Med Rehabil. 1985 Mar;66(3):164-7.
Right hemisphere brain-damaged stroke patients demonstrate a variety of neurologic deficits which seem to impair their ability to regain self-care independence. Visual perceptual and visual search disorders have been implicated with persistent functional deficits. The objective of this study was to measure the extent to which defects of optokinetic nystagmus (OKN), an ocular movement reflex, may be associated with inability to regain independent function. Eighteen right hemisphere brain-damaged stroke patients suffering similar sensory-motor deficits were followed up from admission as they underwent self-care training in a comprehensive stroke rehabilitation center. Ten subjects demonstrated unilateral absence of OKN and eight subjects demonstrated bilaterally intact responses upon admission. Upper extremity (UE) dressing independence was used as an indicator of functional skill level at admission, during treatment, and at discharge. Subjects with unilateral loss of OKN were significantly less independent at admission and at discharge when compared to subjects with intact OKN. Although both groups of patients made statistically significant gains in UE dressing, those with defective OKN had a 40% greater inpatient length of stay and were more likely to be discharged to a nursing home or needed care by a significant other after rehabilitation.
右侧大脑半球损伤的中风患者表现出多种神经功能缺损，这似乎损害了他们重新获得自理独立能力。视觉感知和视觉搜索障碍与持续的功能缺损有关。本研究的目的是测量视动性眼球震颤（OKN）这一眼球运动反射的缺陷与无法恢复独立功能之间的关联程度。18名患有类似感觉运动缺损的右侧大脑半球损伤的中风患者在一家综合性中风康复中心接受自理训练时，从入院开始就被跟踪随访。10名受试者入院时表现为单侧OKN缺失，8名受试者入院时表现为双侧反应正常。上肢（UE）穿衣独立性被用作入院时、治疗期间和出院时功能技能水平的指标。与OKN正常的受试者相比，单侧OKN缺失的受试者在入院时和出院时的独立性明显较差。尽管两组患者在上肢穿衣方面都取得了具有统计学意义的进步，但OKN有缺陷的患者住院时间长40%，更有可能出院后入住养老院或康复后需要重要他人的照顾。
