《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (08): 759-760.

• 临床研究 • 上一篇    下一篇

影响左侧偏瘫患者上肢功能预后的相关因素分析

陈巍1,2; 芦海涛1,2; 张琦1,2; 张通1,2; 纪树荣1,2   

  1. 1.首都医科大学康复医学院,北京市 100068;2.中国康复研究中心博爱医院神经康复科,北京市 100068
  • 收稿日期:2008-07-02 出版日期:2008-08-01 发布日期:2008-08-01

Related Factors Influencing the Prognosis of Upper Limb Function of Stroke Patients with Left Side Hemiplegia

CHEN Wei, LU Hai-tao, ZHANG Qi, et al   

  1. Capital Medical University School of Rehabilitation Medicine, the Department of Neuro-rehabilitation,Beijing Charity Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:2008-07-02 Published:2008-08-01 Online:2008-08-01

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被引次数

2

摘要： 目的探讨影响左侧偏瘫患者上肢功能和日常生活活动(ADL)能力等康复疗效的相关因子。方法对64例脑卒中左侧偏瘫患者进行常规康复训练1个月,治疗前采用简易智能状态检查表(MMSE)、洛文斯顿认知成套测验(LOTCA)、运动保持困难量表(MI)、Schenkenberg等分线段、Albert划线、字母删除试验等量表进行认知功能评测,并于治疗前和治疗后采用Brunnstrom运动功能分期、上田敏偏瘫手指功能评定表、偏瘫上肢能力评定表、改良Barthel指数(MBI)等量表,对患者进行肢体功能及ADL能力评分。应用多元逐步回归分析分析上述因素与上肢功能和ADL能力恢复程度之间的关系。结果患者上肢功能的恢复程度与训练前的LOTCA思维运作能力评分呈明显正相关(P<0.01);手指功能的恢复程度与训练前的MI呈明显负相关(P<0.01);手的实用性恢复程度与训练前的LOTCA的思维运作能力及ADL评分呈明显正相关(P<0.01);ADL的恢复程度与LOTCA的思维运作能力量表得分及病变部位呈明显正相关(P<0.01),与Schenkenberg等分线段量表得分呈明显负相关(P<0.01)。结论康复训练前的LOTCA思维运作能力、Schenkenberg等分线段量表、ADL、MI功能等评分,对卒中后左侧偏瘫患者上肢功能的预后有预测作用。

关键词: 上肢功能, 康复预后, 洛文斯顿认知成套测验, 脑卒中, 运动保持困难

Abstract: Objective To explore the associated factors influencing the prognosis of upper limb function and ability of activities daily living(ADL)in stroke patients with left side hemiplegia.Methods 64 stroke patients with left side hemiplegia were treated regularly last for 1 month.At admission,the assessment procedure for cognitive function were performed with scales of Mini-Mental State Examination(MMSE),Loewenstein Occupational Therapy Cognitive Assessment(LOTCA),Motor Impersistence(MI),Schenkenberg Line Bisection Test.Brunnstrom stage,Modified Barthel Index(MBI),Ueda,Bin Hemiplegic Finger Function Assessment Scale,Upper Limb Function Assessment Scale were graded for the upper limb function and ADL ability before and after training.The multinominal logistic regression analysis was used to analyze the relationship between those factors and the upper limb function and ADL ability.Results The extent of resumption of upper limb function of patients was positively correlated with the ability of formal operational thinking(P<0.01)in LOTCA score before training.However,the extent of resumption of hand was negatively correlated with MI score before training(P<0.01).The extent of resumption of the hand practicability was positively correlated with the ability of operational thinking and score of ADL in LOTCA before training(P<0.01).The extent of the resumption of ADL was positively correlated with the ability score of operational thinking in LOTCA and diseased region.It was negatively correlated with the score of Schenkenberg line bisection(P<0.01).Conclusion The ability of operational thinking in LOTCA before training and the scores of Schenkenberg line bisection,ADL and MI are helpful in prognosis for the upper limb function in stroke patients with left side hemiplegia.

Key words: function of upper limb, rehabilitation prognosis, Loewenstein Occupational Therapy Cognitive Assessment(LOTCA), stroke, motor impersistence