Waters R L, Adkins R H, Yakura J S, Sie I
Regional Spinal Cord Injury Care System of Southern California, Rancho Los Amigos Medical Center, Downey 90242.
Arch Phys Med Rehabil. 1994 Jan;75(1):67-72.
Fifty-four individuals admitted for rehabilitation with a diagnosis of incomplete paraplegia due to trauma underwent serial prospective examinations to quantify motor and sensory recovery. Motor and sensory scoring guidelines recommended by the American Spinal Injury Association were used to assess changes. Lower extremity motor scores (LEMS) differed significantly (p < .03) between groups of patients partitioned by category of initial neurologic level of injury (NLI) with the following averages at 1 month after injury: 6.8 +/- 11.3 above T12, 15.0 +/- 8.2 at T12 and 18.3 +/- 11.4 below T12. However, the amount of motor recovery was independent of the NLI with the differences between the NLI groups remaining essentially constant from 1 month to 2 years. While the LEMS increased significantly (p < .001) an average of 11.9 +/- 8.7 points between 1 month and 1 year, the annualized rate of motor recovery rapidly declined in the first 6 months and then subsequently plateaued. All patients having a 1-month LEMS greater than 10 points (28 cases) with hip flexion or knee extension strength > or = 2/5 were able to ambulate in the community with a reciprocal gait pattern using crutches and orthoses at 1-year follow-up.
54名因创伤导致不完全性截瘫而入院接受康复治疗的患者接受了系列前瞻性检查，以量化运动和感觉恢复情况。采用美国脊髓损伤协会推荐的运动和感觉评分指南来评估变化。根据初始神经损伤水平（NLI）类别划分的患者组之间，下肢运动评分（LEMS）存在显著差异（p <.03），受伤后1个月时的平均值如下：T12以上为6.8 +/- 11.3，T12处为15.0 +/- 8.2，T12以下为18.3 +/- 11.4。然而，运动恢复量与NLI无关，NLI组之间的差异从1个月到2年基本保持不变。虽然LEMS在1个月至1年之间平均显著增加（p <.001）11.9 +/- 8.7分，但运动恢复的年化率在前6个月迅速下降，随后趋于平稳。所有1个月时LEMS大于10分（28例）且髋部屈曲或膝关节伸展力量≥2/5的患者在1年随访时能够使用拐杖和矫形器以交互步态模式在社区中行走。
