脑卒中患者肩关节半脱位的预测因素。

J J Chang, J C Tsau, Y T Lin
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引用次数: 0

摘要

肩半脱位已被认为是偏瘫患者的主要和常见并发症。它可能会恶化,并可能伴有肩部和四肢疼痛、神经损伤和干扰功能活动。本研究的总体目标是研究脑卒中患者肩关节半脱位的重要预测因素,并提出一种早期预防和治疗偏瘫肩关节半脱位的方法。采用回顾性研究,并采用后向逐步logistic回归分析对收集到的资料进行分析。结果显示,Brunnstrom手臂运动分期(beta = -2.480, Wald统计量= 10.03,p = 0.0015)和手臂感觉(触觉)状态(beta = 1.0283, Wald统计量= 3.93,p = 0.0474)是偏瘫肩半脱位的显著预测因子。本研究支持感觉(触觉)损伤可能是偏瘫肩关节半脱位的诱发因素,并强调运动和感觉预防策略在早期预防和治疗肩关节半脱位中的重要性。本研究还讨论了在神经恢复的急性/弛缓期肩关节半脱位的预防策略。
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Predictors of shoulder subluxation in stroke patients.

Shoulder subluxation has been recognized as a major and frequent complication in patients with hemiplegia. It may worsen and may be associated with shoulder and extremity pain, nerve damage, and interfere with functional activities. The overall goal of this study was to examine the significant predictors of shoulder subluxation in stroke patients and to suggest a way of early prevention and management of hemiplegic shoulder subluxation. A retrospective study was performed and backward stepwise logistic regression analysis was used to analyze the available collected data. The result showed that significant predictors of hemiplegic shoulder subluxation were Brunnstrom's arm motor stage (beta = -2.480, the Wald statistic = 10.03, p = 0.0015) and arm sensory (tactile) status (beta = 1.0283, the Wald statistic = 3.93, p = 0.0474). This study supports that sensory (tactile) impairment may be a precipitating factor for hemiplegic shoulder subluxation and it may highlight the importance of both motor and sensory preventive strategies in early prevention and management of shoulder subluxation. The preventive strategies for shoulder subluxation during the acute/flaccid phase of neural recovery are also discussed in this study.

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