https://scholars.lib.ntu.edu.tw/handle/123456789/590489
標題: | Predicting recovery of voluntary upper extremity movement in subacute stroke patients with severe upper extremity paresis | 作者: | Koh C.-L. SHIN-LIANG PAN JIANN-SHING JENG BANG-BIN CHEN Wang Y.-H. I-PING HSUEH CHING-LIN HSIEH |
公開日期: | 2015 | 卷: | 10 | 期: | 5 | 起(迄)頁: | e0126857 | 來源出版物: | PLoS ONE | 摘要: | Background and Objective: Prediction of voluntary upper extremity (UE) movement recovery is largely unknown in patients with little voluntary UE movement at admission. The present study aimed to investigate (1) the extent and variation of voluntary UE movement recovery, and (2) the best predictive model of the recovery of voluntary UE movement by clinical variables in patients with severe UE paresis. Design: Prospective cohort study. Methods: 140 (out of 590) stroke patients with severe UE paresis completed all assessments. Voluntary UE movement was assessed using the UE subscale of the Stroke Rehabilitation Assessment of Movement (STREAM-UE). Two outcome measures, STREAM-UE scores at discharge (DCSTREAM-UE) and changes between admission and discharge (ΔSTREAM-UE), were investigated to represent the final states and improvement of the recovery of voluntary UE movement. Stepwise regression analyses were used to investigate 19 clinical variables and to find the best predictive models of the two outcome measures. Results: The participants showed wide variation in both DCSTREAM-UE and ΔSTREAM-UE. 3.6% of the participants almost fully recovered at discharge (DCSTREAM-UE > 15). A large improvement (ΔSTREAM-UE >= 10) occurred in 16.4% of the participants, while 32.9% of the participants did not have any improvement. The four predictors for the DCSTREAM-UE (R2 = 35.0%) were 'baseline STREAM-UE score', 'hemorrhagic stroke', 'baseline National Institutes of Health Stroke Scale (NIHSS) score', and 'cortical lesion excluding primary motor cortex'. The three predictors for the ΔSTREAM-UE (R2 = 22.0%) were 'hemorrhagic stroke', 'baseline NIHSS score', and 'cortical lesion excluding primary motor cortex'. Conclusions: Recovery of voluntary UE movement varied widely in patients with severe UE paresis after stroke. The predictive power of clinical variables was poor. Both results indicate the complex nature of voluntary UE movement recovery in patients with severe UE paresis after stroke. ? 2015 Koh et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84929359110&doi=10.1371%2fjournal.pone.0126857&partnerID=40&md5=25ee45f4daf0ffaf8d50132b6029cd5d https://scholars.lib.ntu.edu.tw/handle/123456789/590489 |
ISSN: | 19326203 | DOI: | 10.1371/journal.pone.0126857 | SDG/關鍵字: | adult; aged; arm movement; arm paresis; Article; brain cortex lesion; brain hemorrhage; brain infarction; brain ischemia; cerebrovascular accident; clinical assessment tool; cohort analysis; controlled clinical trial; controlled study; convalescence; diagnostic test accuracy study; disease association; disease severity; female; hospital admission; hospital discharge; human; intermethod comparison; kinesiotherapy; major clinical study; male; National Institutes of Health Stroke Scale; outcome assessment; paresis; predictive value; predictor variable; prognosis; rating scale; regression analysis; scoring system; statistical model; Upper Extremity subscale of the Stroke Rehabilitation Assessment of Movement; very elderly; voluntary movement; complication; convalescence; demography; middle aged; motor cortex; nuclear magnetic resonance imaging; paresis; pathology; pathophysiology; prospective study; severity of illness index; Stroke; stroke rehabilitation; upper limb; x-ray computed tomography; Adult; Aged; Aged, 80 and over; Cohort Studies; Demography; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Motor Cortex; Paresis; Prospective Studies; Recovery of Function; Regression Analysis; Severity of Illness Index; Stroke; Stroke Rehabilitation; Tomography, X-Ray Computed; Upper Extremity |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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