Factors associated with upper extremity contractures after cervical spinal cord injury: A pilot study.
Factors associated with upper extremity contractures after cervical spinal cord injury: A pilot study.
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颈脊髓损伤后与上肢挛缩相关的因素：一项试点研究。
DOI：
10.1080/10790268.2017.1331894
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Kilgore,Kevin
中科院分区：
文献类型：
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作者：
Hardwick,Dustin;Bryden,Anne;Kubec,Gina;Kilgore,Kevin
目的：通过对颈髓损伤患者进行方便抽样，研究上肢关节挛缩的患病率及其与随意肌力、神经支配状态、功能状态和人口统计学的相关性，为未来的前瞻性研究提供信息。设计：横断面方便抽样试点研究。设置：退伍军人事务部研究实验室。参与者：38名颈段脊髓损伤的参与者。干预措施：不适用。主要结果测量：采用测角被动活动范围测量挛缩。双侧评价上肢的每个关节。通过手动肌肉测试测量肌肉力量。神经支配状态的临床确定与表面电刺激。脊髓独立性测量III（SCIM-III）。结果：每个参与者测试有多个关节挛缩，平均而言，参与者无法实现被动运动的正常值在52%的关节测试。挛缩最常见于肩部和手部。挛缩率与伤后时间呈弱负相关，挛缩率与年龄呈中度正相关。SCIM-III评分和挛缩百分比之间有很强的负相关性。结论：在超过一半的关节测试中注意到关节挛缩。这些关节挛缩与SCIM-III测量的功能能力下降相关。这突出了需要详细评估手臂和手受伤后的早期，以及在整个生命过程中的四肢瘫痪的个人关节特征的持续监测。
Objective: To examine the prevalence of joint contractures in the upper limb and association with voluntary strength, innervation status, functional status, and demographics in a convenience sample of individuals with cervical spinal cord injury to inform future prospective studies.Design: Cross-sectional convenience sampled pilot study.Setting: Department of Veterans Affairs Research Laboratory.Participants: Thirty-eight participants with cervical level spinal cord injury.Interventions: Not applicable.Main Outcome Measures: Contractures were measured with goniometric passive range of motion. Every joint in the upper extremity was evaluated bilaterally. Muscle strength was measured with manual muscle testing. Innervation status was determined clinically with surface electrical stimulation. Functional independence was measured with the Spinal Cord Independence Measure III (SCIM-III).Results: Every participant tested had multiple joints with contractures and, on average, participants were unable to achieve the normative values of passive movement in 52% of the joints tested. Contractures were most common in the shoulder and hand. There was a weak negative relationship between percentage of contractures and time post-injury and a moderate positive relationship between percentage of contractures and age. There was a strong negative correlation between SCIM-III score and percentage of contractures.Conclusions: Joint contractures were noted in over half of the joints tested. These joint contractures were associated with decreased functional ability as measured by the SCIM-III. This highlights the need the need for detailed evaluation of the arm and hand early after injury as well as continued monitoring of joint characteristics throughout the life course of the individual with tetraplegia.