摘要
目的探讨老年脑卒中患者日常生活活动能力(ADL)与上肢及手运动功能和神经功能状态的相互关系。方法选择2013年1月-2016年12月于华山医院牵头的多家中心医院住院的脑卒中患者742例,其中老年患者164例。所有均接受改良Barthel指数评定(MBI)、WOLF运动功能测试评分表(WMFT)、Fugl-Meyer上肢运动功能评定量表(FMA-UE)、改良Ashworth量表(MAS)、徒手肌力评定(MMT)、上肢Brunnstrom分期(BS)、运动功能状态量表(MSS)和美国国立卫生院神经功能缺损评分表(NIHSS)等的评估。结果164例老年患者ADL与各指标间相关性的强弱排序依次是:上肢运动功能(FMA)=神经功能缺损(NIHSS)>运动状态(MSS)>上肢运动功能分期(BS)>运动质量(WMFT)>肌力(MMT)>痉挛(MAS)。MBI与FMA(r=0.72)、NIHSS(r=-0.72)、MSS(r=0.71)、BS(r=0.70)、WMFT(r=0.67)、屈MTT(r=0.63)和伸MTT(r=0.61),均呈显著相关(P<0.05);而MBI与MAS无相关性(r=0.12,P=0.14)。结论脑卒中后上肢整体运动功能、神经功能状态与老年患者ADL的相关性最强。上肢运动质量、运动状态、上肢及手分期和屈伸肌力也与ADL显著相关。康复治疗师在设计适当的干预措施时,应重视上肢及手的运动整体功能、运动质量、运动状态、运动分期和肌力的恢复,以针对性提高日常生活活动能力、上肢及手运动及神经功能。
Objective To explore the correlation between activities of daily living(ADL)and motor function of upper limbs and hands in elderly stroke patients.Methods 164 elderly stroke inpatients including 164 elderly patients were enrolled in several central hospitals led by Huashan Hospital from 2013 to 2016.All patients were assessed by Modified Barthel Index(MBI)、Wolf Motor Function Test(WMFT)、Fugl-Meyer Assessment(FMA-UE)、Modified Ashworth scale(MAS)、Manual Muscle Test(MMT)、Brunnstrom stage(BS)、Motor Status Scale(MSS)、National Institutes of Health Stroke Scale(NIHSS).Results The order of correlation between ADL and above indexes in 164 elderly patients was:motor function of upper limb(FMA)=neural impairment(NIHSS)>motor status(MSS)>motor stage(BS)>motor quality(WMFT)>muscle strength(MMT)>spasm(MAS).MBI was highly correlated with FMA(r=0.72),NIHSS(r=-0.72),MSS(r=0.71),BS(r=0.70),WMFT(r=0.67),flexor MTT(r=0.63)and extensor MTT(r=0.61)(P<0.05).However,MBI has no correlation with MAS(r=0.12,P=0.14).Conclusion The correlation between the overall function of the upper extremity、the neurological function and ADL is the strongest after stroke in the elderly.ADL was also significantly correlated with motor quality,motor status,limb and hand stages,and flexor and extensor strength.When designing appropriate intervention measures,rehabilitation therapists should pay attention to the recovery of the overall function,quality,state,stage and muscle strength,so as to improve ADL,motor function and nerve function.
作者
林佳丽
田靖
贾杰
Lin Jiali;Tian Jing;Jia Jie(Medicine School of Rehabilitation,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian,350122,P.R.China;Department of Rehabilitation Medicine,Huashan Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2020年第3期362-366,共5页
Geriatrics & Health Care
基金
国家重点研发计划(2018YFC2002300)
国家科技支撑计划专项(2013BAI10B00)。
关键词
老年
脑卒中
日常生活活动能力
运动功能
上肢
康复
elderly
stroke
activities of daily living
motor function
upper extremity
rehabilitation
