FREQUENCY OF DISCRIMINATIVE SENSORY LOSS IN THE HAND AFTER STROKE IN A REHABILITATION SETTING
FREQUENCY OF DISCRIMINATIVE SENSORY LOSS IN THE HAND AFTER STROKE IN A REHABILITATION SETTING
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DOI：
10.2340/16501977-0662
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发表时间：
2011-02-01
影响因子：
3.5
通讯作者：
Matyas, Thomas A.
中科院分区：
文献类型：
--
作者：
Carey, Leeanne M.;Matyas, Thomas A.
目的：中风后体感丧失很常见，对功能结果产生负面影响。然而，现有的研究通常不包括歧视敏感性的定量测量。本研究的目的是量化在急性康复阶段出现手部辨别性感觉丧失的中风患者的比例。设计：对进行康复治疗的中风幸存者进行前瞻性队列研究。患者：连续 12 个月内入住大都市康复中心且符合选择标准的 51 名连续患者。方法：触觉辨别和肢体位置感的定量测量，具有高重测可靠性、良好的辨别测试特性和采用了异常的客观标准。双上肢均按平衡顺序进行测试。结果：47% 的患者在病变对侧的手上发现触觉辨别能力受损，16% 的患者在病变同侧的手上发现触觉辨别能力受损。 49% 的患者对侧肢体位置感受损，20% 的患者同侧肢体位置感受损。百分之六十七的人对侧肢体至少有一种损伤。同侧损伤不太严重。 结论：约一半接受康复治疗的中风患者对侧手有辨别性感觉障碍。临床上显着数量的同病“未受影响”手也经历了损伤。
Objective: Somatosensory loss following stroke is common, with negative consequences for functional outcome. However, existing studies typically do not include quantitative measures of discriminative sensibility. The aim of this study was to quantify the proportion of stroke patients presenting with discriminative sensory loss of the hand in the post-acute rehabilitation phase.Design: Prospective cohort study of stroke survivors presenting for rehabilitation.Patients: Fifty-one consecutive patients admitted to a metropolitan rehabilitation centre over a continuous 12-month period who met selection criteria.Methods: Quantitative measures of touch discrimination and limb position sense, with high re-test reliability, good discriminative test properties and objective criteria of abnormality, were employed. Both upper limbs were tested, in counterbalanced order.Results: Impaired touch discrimination was identified in the hand contralateral to the lesion in 47% of patients, and in the ipsilesional hand in 16%. Forty-nine percent showed impaired limb position sense in the contralesional limb and 20% in the ipsilesional limb. Sixty-seven percent demonstrated impairment of at least one modality in the contralesional limb. Ipsilesional impairment was less severe.Conclusion: Discriminative sensory impairment was quantified in the contralesional hand in approximately half of stroke patients presenting for rehabilitation. A clinically significant number also experienced impairment in the ipsilesional "'unaffected" hand.