Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
Association of Long-Term Treatment by Botulinum Neurotoxins and Occupational Therapy with Subjective Physical Status in Patients with Post-Stroke Hemiplegia
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DOI：
10.3390/toxins11080453
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发表时间：
2019-08-01
期刊：
影响因子：
4.2
通讯作者：
Taguchi, Kensuke
中科院分区：
文献类型：
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作者：
Hamaguchi, Toyohiro;Abo, Masahiro;Taguchi, Kensuke
A型肉毒杆菌毒素（BoNT-A）治疗上肢卒中患者的短期疗效已得到充分证实。本研究探讨了接受长期BoNT-A和职业治疗的门诊患者中风后上肢运动功能恢复与主观躯体症状之间的相关性。我们还调查了选择继续治疗的患者的期望。47名患者（23名男性和24名女性）年龄61岁，接受BoNT-A治疗超过20次。采用视觉模拟量表评分，通过8个项目的问卷调查，对主观身体状况进行分析。通过计算Fugl-Mayer评估（FMA）的变化（delta）检测上肢运动功能的恢复，并使用有序逻辑模型分析来确定delta-FMA评分与每个项目的主观一致性水平之间的相关性。当有序逻辑建模拟合具有统计学显著性时，结果被解释为具有逻辑概率。以逐步方式拟合区分一个点（强烈不同意）和五个点（强烈同意）的逻辑曲线。这项研究表明，接受长期BoNT-A治疗和职业治疗的患者在注射后上肢缓解增加，失眠减少，无论运动功能恢复如何。
The short-term effects of botulinum toxin type A (BoNT-A) treatment in stroke patients with upper extremity are well established. This study examined the association between the recovery of motor function of the upper extremity with subjective physical symptoms in outpatients receiving long-term BoNT-A and occupational therapy following stroke. We also investigated the expectations of patients who elected to continue treatment. Forty-seven patients (23 men and 24 women) aged 61 years received BoNT-A treatment more than 20 times. The subjective physical status was analyzed by using the visual analogue scale score through an eight-item questionnaire. Recovery of motor function in the upper extremity was detected by calculating the change (delta) in Fugl-Mayer Assessment (FMA), and ordinal logistic modeling analysis was used to determine the association between the delta-FMA score and the subjective level of agreement for each item. When the ordinal logistic modeling fit was statistically significant, results were interpreted as having logistic probability. The logistic curves discriminating one point (strongly disagree) from five points (strongly agree) were fit in a stepwise fashion. This study suggests that patients receiving long-term BoNT-A treatment and occupational therapy experienced an increased upper extremity mitigation and decreased insomnia after injection, regardless of the recovery of motor function.