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Isokinetic Measurement of Trunk Muscle Strength in Women with Chronic Low-Back Pain 慢性腰痛女性躯干肌肉力量的等速测量
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00004
M. Bayramoğlu, M. N. Akman, Ş. Kılınç, N. Çetin, N. Yavuz, R. Özker
Bayramoğlu M, Akman MN, Kılınç Ş, Çetin N, Yavuz N, Özker R: Isokinetic measurement of trunk muscle strength in women with chronic low-back pain. Am J Phys Med Rehabil 2001;80:650–655. Objectives: To investigate the relationships among chronic low-back pain and obesity, total spinal range of motion, and trunk muscle strength. The short-term impact of trunk muscle strengthening exercises on this condition was also examined. Design: A controlled, prospective study of trunk muscle strengths of patients with chronic low-back pain and the short-term impact of exercise on strength. The study group consisted of 25 female patients who had been experiencing low-back pain for at least 3 mo, and the control group included 20 age-matched women without known low-back trouble. The Davenport Index was used to calculate the body mass indexes of all subjects. The Oswestry Disability Questionnaire was used to assess pain in the study group. Full flexion and extension ranges of motion were measured, then isokinetic measurements of trunk muscles were performed at 60-, 120-, and 180-degrees/sec velocities. Isometric measurements were also recorded for both flexors and extensors at a 60-degree angle. Results: Increased body mass index and decreased trunk muscle strength were found to be directly associated with chronic low-back pain (P < 0.05). After a 15-day standard trunk strengthening exercise program in the patient group, trunk muscle strength was found to be increased (P < 0.05). Conclusions: Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.
Bayramoğlu M, Akman MN, Kılınç Ş, Çetin N, Yavuz N, Özker R:慢性腰痛女性躯干肌肉力量的等速测量。[J]中华医学杂志,2001;16(2):559 - 561。目的:探讨慢性腰痛与肥胖、脊柱总活动度和躯干肌力的关系。我们还研究了躯干肌肉强化训练对这种情况的短期影响。设计:一项关于慢性腰痛患者躯干肌肉力量和运动对力量的短期影响的对照前瞻性研究。研究组由25名患有腰痛至少3个月的女性患者组成,对照组包括20名年龄匹配且无腰痛的女性。采用达文波特指数计算所有受试者的身体质量指数。使用Oswestry残疾问卷评估研究组的疼痛。测量完整的屈曲和伸展运动范围,然后以60度、120度和180度/秒的速度进行躯干肌肉等速测量。还记录了屈肌和伸肌在60度角的等距测量。结果:体重指数升高、躯干肌力下降与慢性腰痛有直接关系(P < 0.05)。患者组进行15天标准躯干强化训练后,躯干肌力明显增强(P < 0.05)。结论:肥胖和躯干肌力下降是引起慢性腰痛的重要因素,实施躯干肌力强化方案有助于减轻腰痛。
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引用次数: 158
Resident Research Education in Physical Medicine and Rehabilitation: A Practical Approach 物理医学与康复住院医师研究教育:一种实用方法
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00013
M. Boninger, L. Chan, R. Harvey, Z. Pine, Wendy M. Helkowski, Christopher J. Garrison, T. Tran, H. Levin, C. Levy
Boninger ML, Chan L, Harvey R, et al: Resident research education in physical medicine and rehabilitation: a practical approach. Am J Phys Med Rehabil 2001;80:706–712.The Accreditation Council for Graduate Medical Education includes training in research as a required component of physical medicine and rehabilitation residency programs. Unfortunately, there is a lack of practical information on how to meet this requirement. In this paper, information is provided for individuals involved in resident education on how to teach residents about research.
Boninger ML, Chan L, Harvey R,等:物理医学和康复住院医师研究教育:一种实用方法。[J]中华医学杂志,2001;30(2):391 - 391。研究生医学教育认证委员会将研究培训作为物理医学和康复住院医师项目的必要组成部分。不幸的是,缺乏关于如何满足这一需求的实用信息。本文为参与居民教育的个人提供了有关如何向居民教授研究的信息。
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引用次数: 15
Role of Agitation in Prediction of Outcomes After Traumatic Brain Injury 躁动在预测外伤性脑损伤后预后中的作用
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00002
J. Bogner, J. Corrigan, L. Fugate, W. Mysiw, D. Clinchot
Bogner JA, Corrigan JD, Fugate L, Mysiw WJ, Clinchot D: Role of Agitation in Prediction of Outcomes After Traumatic Brain Injury. Am J Phys Med Rehabil 2001;80:636–644. Objective: To determine the role of agitation in the prediction of traumatic brain injury rehabilitation outcomes. Design: A longitudinal study of 340 consecutive patients admitted to an acute traumatic brain injury rehabilitation unit was conducted. Outcomes under study included rehabilitation length of stay, discharge destination, functional independence at discharge (FIMTM instrument), productivity at 1-yr follow-up, and life satisfaction at 1-yr follow-up (Satisfaction with Life Scale). Results: Univariate analyses suggested that the presence of agitation in rehabilitation is predictive of a longer length of stay and decreased functional independence in the cognitive realm at discharge. In addition, individuals who exhibit agitation at any time during rehabilitation are less likely to be discharged to a private residence. However, multivariate analyses indicated that cognitive functioning at admission to rehabilitation (FIM cognitive) mediates the relationship between the presence of agitation and length of rehabilitation, as well as between agitation and FIM cognitive at discharge. Similar results were found when discharge residence was the dependent variable; however, agitation also contributed some unique variance to the prediction. Lower cognitive functioning at admission to rehabilitation was associated with the occurrence of agitation during rehabilitation, longer length of stay, lower cognitive functioning at discharge, and a decreased likelihood that an individual would be discharged to a private residence. Conclusions: The results of the multivariate analyses support the contention that agitation and cognition are intimately related, with the long-term effects of the former being at least partially driven by the latter. These findings support the importance of systematically monitoring both agitation and cognition when applying interventions to reduce agitation.
张建军,张建军,张建军,张建军。躁动对创伤性脑损伤患者预后的影响。[J]中华医学杂志,2001;19(2):344 - 344。目的:探讨躁动在预测外伤性脑损伤康复预后中的作用。设计:对340名连续入住急性创伤性脑损伤康复病房的患者进行了纵向研究。研究结果包括康复住院时间、出院目的地、出院时的功能独立性(FIMTM仪器)、1年随访时的工作效率和1年随访时的生活满意度(生活满意度量表)。结果:单变量分析表明,康复过程中出现躁动预示着出院时认知领域功能独立性下降和住院时间延长。此外,在康复期间任何时候表现出躁动的个体不太可能出院到私人住宅。然而,多变量分析表明,康复入院时的认知功能(FIM认知)在躁动的存在与康复时间之间以及出院时的躁动与FIM认知之间起中介作用。当出院居住地为因变量时,结果相似;然而,躁动也对预测产生了一些独特的差异。入院时较低的认知功能与康复期间躁动的发生、较长的住院时间、出院时较低的认知功能以及个体出院到私人住所的可能性降低有关。结论:多变量分析的结果支持躁动和认知密切相关的论点,前者的长期影响至少部分由后者驱动。这些发现支持在应用干预措施减少躁动时系统监测躁动和认知的重要性。
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引用次数: 99
Predicting Outcomes of Patients in Japan After First Acute Stroke Using a Simple Model 用简单模型预测日本患者首次急性中风后的预后
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00003
M. Inouye
Inouye M: Predicting outcomes of patients in Japan after first acute stroke using a simple model. Am J Phys Med Rehabil 2001;80:645–649. Objective: Prediction of patient outcome can be useful as an aid to clinical decision making. Many studies, including my own, have constructed predictive multivariate models for outcome following stroke rehabilitation therapy, but these have often required several minutes work with a pocket calculator. The aim is to develop a simple, easy-to-use model that has strong predictive power. Methods: Four hundred sixty-four consecutive patients with first stroke who were admitted to a rehabilitation hospital during a period of 19 mo were enrolled in the study. Sex, age, the stroke type, Functional Independence Measure total score on admission (X), onset to admission interval (number of days from stroke onset to rehabilitation admission), and length of rehabilitation hospital stay (number of days from hospital admission to discharge) were the independent variables. Functional Independence Measure total score at discharge (Y) was the dependent variable. Results: Stepwise multiple regression analysis resulted in the model containing age (P < 0.0001), X (P < 0.0001), and onset to admission interval (P < 0.0001). The equation was:Y = 68.6 − 0.32 (age) + 0.80 X − 0.13 (onset to admission interval), a multiple correlation coefficient (R) = 0.82, and a multiple correlation coefficient squared (R2) = 0.68. Simple regression analysis revealed the relation between X and Y:Y = 0.85 X + 37.36, and R = 0.80, R2 = 0.64. In fact, plots of X vs. Y were nonlinear, but seemed to be able to be linearized by some form of equation. It was found that there is a linear relation between log X and Y. The equation is Y = 106.88 x − 95.35, where x = log X, R = 0.84, and R2 = 0.70. The correlation is improved by a regression analysis of a natural logarithmic transformation of X (R = 0.84 vs. R = 0.82). Conclusion: The results in this study confirm that the simple regression model using a logarithmic transformation of X (R = 0.84) has predictive power over the simple regression model (R = 0.80). This model is well validated and clinically useful.
Inouye M:用一个简单的模型预测日本患者首次急性中风后的预后。[J]中华医学杂志,2001;16(2):444 - 444。目的:预测患者预后可作为临床决策的辅助手段。许多研究,包括我自己的研究,已经为中风康复治疗后的结果构建了预测的多变量模型,但这些模型通常需要几分钟的工作时间和一个袖式计算器。其目的是开发一个简单,易于使用的模型,具有强大的预测能力。方法:464例连续19个月住院的首次中风患者被纳入研究。性别、年龄、脑卒中类型、入院时功能独立性测量总分(X)、发病至入院间隔(脑卒中发病至康复入院天数)和康复住院时间(入院至出院天数)为自变量。出院时功能独立性测量总分(Y)为因变量。结果:逐步多元回归分析得到了包含年龄(P < 0.0001)、X (P < 0.0001)、发病至入院间隔(P < 0.0001)的模型。方程为:Y = 68.6−0.32(年龄)+ 0.80 X−0.13(发病至入院间隔),多重相关系数(R) = 0.82,多重相关系数平方(R2) = 0.68。简单回归分析显示X与Y的关系:Y = 0.85 X + 37.36, R = 0.80, R2 = 0.64。事实上,X和Y的曲线是非线性的,但似乎可以通过某种形式的方程线性化。结果表明,log X与Y之间存在线性关系,方程为Y = 106.88 X−95.35,其中X = log X, R = 0.84, R2 = 0.70。相关性通过X的自然对数变换的回归分析得到改善(R = 0.84 vs. R = 0.82)。结论:本研究结果证实,采用X的对数变换的简单回归模型(R = 0.84)比简单回归模型(R = 0.80)具有预测能力。该模型得到了很好的验证和临床应用。
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引用次数: 29
Intersection Syndrome in Buriram Hospital: A 4-yr Prospective Study Buriram医院的交叉综合征:一项4年前瞻性研究
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00005
Somphop Pantukosit, W. Petchkrua, S. Stiens
Pantukosit S, Petchkrua W, Stiens SA: Intersection syndrome in Buriram Hospital: a 4-yr prospective study. Am J Phys Med Rehabil 2001;80:656–661. Objective: To determine the prevalence, demographic characteristics, symptoms, treatment, and outcome of patients who presented to Buriram Provincial hospital and were diagnosed with intersection syndrome. Design: This was a 4-yr prospective study that included all patients with new complaints of forearm and hand pain who presented to Buriram hospital as inpatients or outpatients. Results: The prevalence of intersection syndrome was found to be 0.37% of all patients (8080) with arm or hand pain. Of the 30 patients presenting with intersection syndrome, all had forearm pain, 22 (73.3%) had swelling, and 12 (40%) had crepitus noted in the intersected region. Fourteen (46.7%) patients reported pain provoked with twisting hand motions with radial deviations, 4 (13.3%) with pulling, and 12 (40%) with combinations of multiple hand movements (threshing, planting, hammering, hand washing, spraying and cementing). The majority of the patients were male (70%) farmers (60%). Twenty-nine patients received nonoperative treatment, including modified work activities to reduce stress on the wrist, nonsteroidal anti-inflammatory, and analgesic medications. One patient received only analgesic medication. One patient additionally required a resting hand splint. Every patient was seen for follow-up within the next 7 days. By 12–18 months posttreatment, there were only 14 patients (46.6%) remaining in follow-up, none with any symptom recurrence. Conclusion: Intersection syndrome is a relatively uncommon, overused syndrome that is associated with repeated radial deviation of the wrist and responds favorably to conservative treatment.
Pantukosit S, Petchkrua W, Stiens SA: Buriram医院交叉综合征的4年前瞻性研究。[J]中华医学杂志,2001;16(2):559 - 561。目的:确定在Buriram省医院就诊并被诊断为交叉综合征的患者的患病率、人口学特征、症状、治疗和预后。设计:这是一项为期4年的前瞻性研究,纳入了所有在Buriram医院住院或门诊就诊的前臂和手部疼痛新主诉患者。结果:8080例手臂或手痛患者中,交叉综合征患病率为0.37%。在30例表现为交叉综合征的患者中,所有患者均有前臂疼痛,22例(73.3%)有肿胀,12例(40%)在交叉区有肌痛。14例(46.7%)患者报告疼痛是由扭曲的手部运动引起的,4例(13.3%)是由拉扯引起的,12例(40%)是由多种手部运动组合引起的(脱粒、种植、锤击、洗手、喷洒和粘接)。以男性(70%)和农民(60%)居多。29例患者接受非手术治疗,包括改进工作活动以减轻手腕压力、非甾体抗炎和镇痛药物。一名患者仅接受镇痛药物治疗。一名患者还需要一个静置的手部夹板。所有患者均在7天内接受随访。治疗后12-18个月,仅14例(46.6%)患者仍在随访,无任何症状复发。结论:交叉综合征是一种相对不常见的过度使用综合征,与反复的腕关节桡侧偏有关,保守治疗效果良好。
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引用次数: 38
Nontraumatic vs. Traumatic Spinal Cord Injury: A Rehabilitation Outcome Comparison 非创伤性与创伤性脊髓损伤:康复结果比较
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00010
W. Mckinley, R. Seel, Ramakrishna K. Gadi, Michael A. Tewksbury
McKinley WO, Seel RT, Gadi RK, Tewksbury MA: Nontraumatic vs. traumatic spinal cord injury: a rehabilitation outcome comparison. Am J Phys Med Rehabil 2001;80:693–699. Objective: Nontraumatic spinal cord injury (SCI) represents a significant proportion of individuals admitted for SCI rehabilitation; however, there is limited literature regarding their outcomes. As our society continues to age and nontraumatic injuries present with greater frequency, further studies in this area will become increasingly relevant. The objective of this study was to compare outcomes of patients with nontraumatic SCI with those with traumatic SCI after inpatient rehabilitation. Design: A longitudinal study with matched block design was used comparing 86 patients with nontraumatic SCI admitted to a SCI rehabilitation unit and 86 patients with traumatic SCI admitted to regional model SCI centers, controlling for age, neurologic level of injury, and American Spinal Injury Association impairment classification. Main outcome measures included acute and rehabilitation hospital length of stay, FIMTM scores, FIM change, FIM efficiency, rehabilitation charges, and discharge-to-home rates. Results: Results indicate that when compared with traumatic SCI, patients with nontraumatic SCI had a significantly (P < 0.01) shorter rehabilitation length of stay (22.38 vs. 41.35 days) and lower discharge FIM scores (57.3 vs. 65.6), FIM change (18.6 vs. 31.0), and rehabilitation charges ($25,050 vs. $64,570). No statistical differences were found in acute care length of stay, admission FIM scores, FIM efficiency, and community discharge rates. Conclusions: The findings indicate that patients with nontraumatic SCI can achieve rates of functional gains and community discharge comparable with traumatic SCI. Whereas patients with traumatic SCI achieved greater overall functional improvement, patients with nontraumatic SCI had shorter rehabilitation length of stay and lower rehabilitation charges. These findings have important implications for the interdisciplinary rehabilitation process in the overall management and outcome of individuals with nontraumatic SCI.
mcmckinley WO, Seel RT, Gadi RK, Tewksbury MA:非创伤性与创伤性脊髓损伤:康复结果比较。[J]中华医学杂志,2001;19(2):391 - 391。目的:非创伤性脊髓损伤(SCI)在接受SCI康复治疗的个体中占很大比例;然而,关于其结果的文献有限。随着我们社会的持续老龄化和非创伤性损伤出现的频率越来越高,这一领域的进一步研究将变得越来越重要。本研究的目的是比较非创伤性脊髓损伤患者和创伤性脊髓损伤患者住院康复后的预后。设计:采用匹配块设计的纵向研究,比较86例住进脊髓损伤康复中心的非外伤性脊髓损伤患者和86例住进区域模型脊髓损伤中心的外伤性脊髓损伤患者,控制年龄、损伤的神经系统水平和美国脊髓损伤协会的损伤分类。主要结局指标包括急性和康复住院时间、FIM评分、FIM变化、FIM效率、康复费用和出院回家率。结果:结果表明,与创伤性脊髓损伤患者相比,非创伤性脊髓损伤患者的康复住院时间(22.38天比41.35天)明显缩短(P < 0.01),出院FIM评分(57.3比65.6),FIM变化(18.6比31.0)和康复费用(25,050美元比64,570美元)较低。在急症护理住院时间、入院FIM评分、FIM效率和社区出院率方面均无统计学差异。结论:研究结果表明,与外伤性脊髓损伤相比,非外伤性脊髓损伤患者的功能恢复和社区出院率可达到相当的水平。创伤性脊髓损伤患者获得了更大的整体功能改善,而非创伤性脊髓损伤患者的康复时间更短,康复费用更低。这些发现对非创伤性脊髓损伤患者的综合管理和预后的跨学科康复过程具有重要意义。
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引用次数: 107
Developing Meaningful Fear of Falling Measures for Community Dwelling Elderly 为居住在社区的长者制订有意义的恐惧跌倒措施
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00006
C. Velozo, E. Peterson
Velozo CA, Peterson EW: Developing meaningful fear of falling measures for community dwelling elderly. Am J Phys Med Rehabil 2001:80:662–673. Objective: The objective of this study is to demonstrate how a Rasch analytic approach can be used to create fear of falling measures that remain connected to the meaningful descriptions provided by the instrument items. Design: The University of Illinois at Chicago Fear of Falling Measure was developed using focus groups and consists of 19 common activities designed to represent an increasing level of concern about falling among older adults. Results: Rasch analysis of responses from 106 community dwelling elderly revealed that the two middle rating scale categories (a little worried and moderately worried) were not being used in the expected fashion. After modification of the rating scale, Rasch analysis showed that the three items causing the least worry (get dressed, get on/off toilet, and get in/out of bed) were statistically erratic. Conclusion: Final analysis demonstrated that the remaining 16 items represented a unidimensional construct that, in general, supported the original expected item difficulty hierarchy. Because person and item measures were calibrated on the same linear scale person measures are translatable to item descriptions. This connection provides meaning to the numeric values obtained from the instrument and provides a basis for setting clinically relevant criteria for interventions.
Velozo CA, Peterson EW:为社区居住的老年人制定有意义的恐惧措施。[J] .中华医学杂志,2001(4):368 - 368。目的:本研究的目的是展示如何使用Rasch分析方法来创建与仪器项目提供的有意义的描述保持联系的对坠落的恐惧措施。设计:伊利诺伊大学芝加哥分校的“跌倒恐惧测量”是由焦点小组开发的,由19个常见活动组成,旨在代表老年人对跌倒的日益关注程度。结果:对106名社区居住老年人的回复进行Rasch分析,发现两个中间等级的量表类别(有点担心和中等担心)的使用没有达到预期的方式。在修改了评定量表后,Rasch的分析显示,最不令人担心的三个项目(穿衣服、上/下厕所和上床/下床)在统计上是不稳定的。结论:最后的分析表明,剩下的16个项目代表了一个单维结构,总的来说,支持最初预期的项目难度等级。因为人的测量和项目的测量是在相同的线性尺度上校准的人的测量可以翻译成项目的描述。这种联系为从仪器中获得的数值提供了意义,并为制定干预的临床相关标准提供了基础。
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引用次数: 111
Multicenter Clinical Trials to Establish the Benefit of Early Intervention in Spinal Cord Injury 建立脊髓损伤早期干预益处的多中心临床试验
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00014
J. Ditunno
Ditunno JF Jr: Multicenter clinical trials to establish the benefit of early intervention in spinal cord injury. Am J Phys Med Rehabil 2001;80:713–716.
Ditunno JF Jr:多中心临床试验以确定早期干预对脊髓损伤的益处。[J]中华医学杂志,2001;16(2):379 - 379。
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引用次数: 1
Manual and Oral Apraxia in Acute Stroke, Frequency and Influence on Functional Outcome: The Copenhagen Stroke Study 哥本哈根卒中研究:急性卒中的手和口失用症,频率和对功能结局的影响
Pub Date : 2001-09-01 DOI: 10.1097/00002060-200109000-00008
Palle M/oller Pedersen, Henrik Stig J/orgensen, L. Kammersgaard, H. Nakayama, H. Raaschou, T. S. Olsen
Pedersen PM, J/orgensen HS, Kammersgaard LP, Nakayama H, Raaschou HO, Olsen TS: Manual and oral apraxia in acute stroke, frequency and influence on functional outcome: the Copenhagen Stroke Study. Am J Phys Med Rehabil 2001;80:685–692. Objectives: To determine the frequency of manual and oral apraxia in acute stroke and to examine the influence of these symptoms on functional outcome. Design: Seven hundred seventy six unselected, acute stroke patients who were admitted within seven days of stroke onset with unimpaired consciousness were included. If possible, the patients were assessed for manual and oral apraxia on acute admission. Neurologic stroke severity including aphasia was assessed with the Scandinavian Stroke Scale, and activities of daily living function was assessed with the Barthel Index. All patients completed their rehabilitation in the same large stroke unit. Results: Six hundred eighteen patients could cooperate with the apraxia assessments. Manual apraxia was found in 7% of subjects (10% in left and 4% in right hemispheric stroke; &khgr;2= 9.0;P = 0.003). Oral apraxia was found in 6% (9% in left and 4% in right hemispheric stroke; &khgr;2= 5.4;P = 0.02). Both manual and oral apraxia were related to increasing stroke severity, and manual, but not oral, apraxia was associated with increasing age. There was no gender difference in frequency of apraxia. Patients with either type of apraxia had temporal lobe involvement more often than patients without. When analyzed with multiple linear and logistic regression analyses, neither manual nor oral apraxia had any independent influence on functional outcome. Conclusion: Apraxia is significantly less frequent in unselected patients with acute stroke than has previously been assumed and has no independent negative influence on functional outcome.
王晓明,王晓明,王晓明,王晓明。急性脑卒中患者手、口失用症的发生频率及影响因素:哥本哈根卒中研究。[J]中华医学杂志,2001;16(2):387 - 398。目的:确定急性脑卒中中手部和口腔失用症的发生频率,并探讨这些症状对功能预后的影响。设计:纳入776名未入选的急性中风患者,这些患者在中风发作后7天内入院,意识未受损。如果可能,在急性入院时评估患者的手部和口腔失用症。用斯堪的纳维亚卒中量表评估失语等神经性卒中严重程度,用Barthel指数评估日常生活功能活动。所有患者均在同一大卒中单元完成康复。结果:618例患者能配合语用障碍评估。7%的受试者存在手用失用症(左脑卒中10%,右脑卒中4%;&khgr;2= 9.0;P = 0.003)。口腔失用症发生率为6%(左半球9%,右半球4%);&khgr;2= 5.4;P = 0.02)。手用和口用失用都与中风严重程度的增加有关,手用失用与年龄的增长有关,而口用失用与年龄无关。失用症的发生频率无性别差异。有任何一种失用症的患者都比没有失用症的患者更容易累及颞叶。当用多元线性和逻辑回归分析分析时,手用和口用失用对功能结局都没有任何独立的影响。结论:失用症在未选择的急性脑卒中患者中的发生率明显低于之前的假设,并且对功能结局没有独立的负面影响。
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引用次数: 36
期刊
American Journal of Physical Medicine and Rehabilitation
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