Contractures in the post-stroke wrist: a pilot study of its time course of development and its association with upper limb recovery
Contractures in the post-stroke wrist: a pilot study of its time course of development and its association with upper limb recovery
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DOI：
10.1191/0269215503cr587oa
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发表时间：
2003-01-01
影响因子：
3
通讯作者：
Granat, MH
中科院分区：
文献类型：
--
作者：
Pandyan, AD;Cameron, M;Granat, MH
背景资料：挛缩是常见的中风人口，但有关于发展的时间过程中的信息很少Objectives：调查定量变化与挛缩形成在急性中风population.Study设计：纵向研究22名科目谁是2-4 wk poststroke.Outcome措施：挛缩进行了评估，通过量化的休息姿势，被动运动和被动运动范围的阻力。上肢功能的测量采用行动研究手臂测试和九孔桩测试。主动伸展范围、腕关节伸展力量重复测量：在初步评估后，在招募后4、8、20和32周进行重复测量。结果：两个不同的亚组，一个能够进行某些功能性运动在研究开始时，确定了另一组受试者（F组-，8例受试者）和另一组未受试者（NF组-，14例受试者）。NF组显示与腕部挛缩形成相关的变化，即，被动运动范围减小，被动运动阻力增加，屈曲姿势恶化。尽管忽视情况有所改善，但从招募时起就观察到了变化。F组表现出改善上肢功能，并没有证据支持挛缩formation.Conclusions：受试者最容易挛缩形成的是那些没有迹象表明早期功能恢复（中风后2-4周）。从研究期第4周开始观察到与适应性缩短一致的变化。
Background: Contractures are common in a stroke population, yet there is little information on the time course of development.Objectives: Investigate quantitatively changes associated with contracture formation in an acute stroke population.Study design: Longitudinal study on 22 subjects who were 2-4 weeks post stroke.Outcome measures: Contractures were assessed by quantifying the resting posture, resistance to passive movement and passive range of movement. Upper limb function was measured using the Action Research Arm Test and the Nine-Hole Peg Test. Active range of extension, wrist extension strength (isometric), grip strength and neglect were also measured.Repeated measures: Following an initial assessment, repeated measurements were taken at 4, 8, 20 and 32 weeks after recruitment.Results: Two distinct subgroups, one capable of some functional movement (F group-, 8 subjects) and another which was not (NF group-, 14 subjects), were identified at the start of the study. The NF group showed changes associated with contracture formation at the wrist, i.e., reduction in the passive range of movement, an increase in resistance to passive movement and a worsening of the flexion posture. Changes were observed from the time of recruitment even though neglect improved. The F group showed improvements in upper limb function and there was no evidence to support contracture formation.Conclusions: Subjects most prone to contracture formation were those who showed no signs of early functional recovery (2-4 weeks after the stroke). Changes consistent with adaptive shortening were seen from week 4 of the study period.