Relationship Between Arm Usage and Instrumental Activities of Daily Living After Unilateral Stroke
Relationship Between Arm Usage and Instrumental Activities of Daily Living After Unilateral Stroke
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DOI：
10.1016/j.apmr.2012.05.011
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发表时间：
2012-11-01
影响因子：
4.3
通讯作者：
Adair, John C.
中科院分区：
文献类型：
--
作者：
Haaland, Kathleen Y.;Mutha, Pratik K.;Adair, John C.
目的：确定单侧大脑半球损伤后手臂使用的首选模式是否与更好的日常功能相关。我们以前的研究表明，右半球损伤（RHD）的右利手中风患者最常使用他们的右同侧手臂，而左半球损伤（LHD）的患者最常使用双臂。这种效应可以用右手偏好来解释，但其与功能表现的关系尚不清楚。设计：观察性队列。设置：研究实验室。参与者：中风患者（n = 60; 30例RHD，30例LHD）和健康对照组（n = 52）。干预：不适用。主要结果测量：功能影响评估被用来评估性能的工具性日常生活活动（IADLs.Results）：手臂使用的首选模式是相似的，在我们以前的报告。然而，在两个卒中组中，更多地使用双臂与更好的IADL表现相关。单独使用同侧臂与RHD组的IADL性能并不显著相关，与LHD组的性能较差相关。结论：模态臂使用模式并不总是优化IADL功能。两个中风组中更好的IADL功能与双臂一起使用相关，这是健康个体进行相同IADL的最常见手臂使用模式。从这些发现中产生的一个重要的实际问题是是否应该强调双侧手臂康复，因为同时使用双臂是日常任务表现更好的最佳预测因素。
Objective: To determine whether the preferred pattern of arm use after unilateral hemispheric damage was associated with better everyday functioning. Our previous work showed that right-handed stroke patients with right hemisphere damage (RHD) used their right, ipsilesional arm most frequently, while those with left hemisphere damage (LHD) used both arms together most frequently. This effect was explained by right-hand preference, but its relationship to functional performance is not known.Design: Observational cohort.Setting: Research laboratory.Participants: Stroke patients (n = 60; 30 RHD, 30 LHD) and healthy controls (n = 52).Interventions: Not applicable.Main Outcome Measures: The Functional Impact Assessment was used to assess performance on instrumental activities of daily living (IADLs).Results: The preferred patterns of arm use were similar to those in our previous report. However, it was the greater use of both arms together that was associated with better IADL performance in both stroke groups. Ipsilesional arm use alone was not significantly associated with IADL performance in the RHD group and was associated with poorer performance in the LHD group.Conclusions: The modal arm use pattern did not always optimize IADL functioning. Better IADL functioning in both stroke groups was associated with the use of both arms together, which is the most common arm use pattern of healthy individuals doing these same IADLs. An important practical question that arises from these findings is whether bilateral arm rehabilitation should be emphasized, because using both arms together is the best predictor of better performance on everyday tasks.