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脊髓损伤患者的运动、感觉和功能恢复

Motor, sensory and functional recovery in patients with spinal cord lesions.

作者信息

Müslümanoğlu L, Aki S, Oztürk Y, Soy D, Filiz M, Karan A, Berker E

机构信息

Department of Physical Medicine and Rehabilitation, Istanbul Medical School Istanbul-Turkey, Turkey.

出版信息

Spinal Cord. 1997 Jun;35(6):386-9. doi: 10.1038/sj.sc.3100406.

Abstract

The aim of this study is to evaluate the sensory, motor and functional improvement in patients with a Spinal Cord Lesion (SCL) by recording at admission, discharge and at 12 months after discharge. Fifty-five patients (29 with paraplegia and 26 with tetraplegia) admitted to our departments of Physical Medicine and Rehabilitation between December 1992-1995. Three patients were excluded as they did not give their consent. Each patient was evaluated at admission, before discharge and at 12 months after discharge. Motor status was evaluated by the motor score (MS), sensory status by the light touch score (LTS), and functional status by the Functional Independence Measure (FIM) score. Each patient was asked to complete a patient questionnaire which was developed according to the standards of the American Spinal Injury Association (ASIA) scale. Twelve patients (10 with paraplegia and two with tetraplegia) were evaluated at 12 months after discharge. Paired samples t-test was used for statistical analysis. The mean age of the patients group was 36.42 +/- 17.70 years, the mean duration of inpatient rehabilitation was 93.87 +/- 44.95 days. The SCL was due to trauma in 45 patients, 86.50% of the cases and was complete in nine patients (17.30%) and incomplete in 19 (36.53%) with paraplegia. Six tetraplegic patients (11.53%) had complete and 18 had (34.61%) incomplete lesions. The evaluation of MS, LTS and FIM scores at admission and discharge showed significant improvement in the MS and LTS in all of the patients with incomplete lesions (P < 0.001). FIM scores showed significant improvement only in those with complete or incomplete paraplegia (P < 0.05). At 12 months follow-up there was no significant change in the MS and the LTS whereas a significant change was noted in the FIM scores (P < 0.05) in 10 paraplegic patients. In summary, the results of this study indicate that rehabilitation was effective in our SCL series although the significant gain may also be attributed to the fact that 71.1% of the study group had incomplete neurological lesions.

摘要

本研究的目的是通过在入院时、出院时以及出院后12个月进行记录,评估脊髓损伤(SCL)患者的感觉、运动和功能改善情况。1992年12月至1995年间,55例患者(29例截瘫和26例四肢瘫)入住我们的物理医学与康复科。3例患者因未给予同意而被排除。每位患者在入院时、出院前和出院后12个月接受评估。运动状态通过运动评分(MS)评估,感觉状态通过轻触觉评分(LTS)评估,功能状态通过功能独立性测量(FIM)评分评估。每位患者被要求完成一份根据美国脊髓损伤协会(ASIA)量表标准制定的患者问卷。12例患者(10例截瘫和2例四肢瘫)在出院后12个月接受评估。采用配对样本t检验进行统计分析。患者组的平均年龄为36.42±17.70岁,住院康复的平均时长为93.87±44.95天。45例患者(86.50%的病例)的SCL是由创伤引起的,其中9例(17.30%)为完全性损伤,19例(36.53%)截瘫患者为不完全性损伤。6例四肢瘫患者(11.53%)为完全性损伤,18例(34.61%)为不完全性损伤。入院时和出院时MS、LTS和FIM评分的评估显示,所有不完全性损伤患者的MS和LTS均有显著改善(P<0.001)。FIM评分仅在完全性或不完全性截瘫患者中有显著改善(P<0.05)。在12个月的随访中,10例截瘫患者的MS和LTS没有显著变化,而FIM评分有显著变化(P<0.05)。总之,本研究结果表明,尽管显著改善可能也归因于71.1%的研究组患者有不完全性神经损伤这一事实,但康复治疗在我们的SCL系列中是有效的。

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