Factors Influencing Sitting Ability During the Acute Post-Stroke Phase: A Multicenter Prospective Cohort Study in Japan
Factors Influencing Sitting Ability During the Acute Post-Stroke Phase: A Multicenter Prospective Cohort Study in Japan
复制标题
影响急性中风后阶段坐立能力的因素：日本多中心前瞻性队列研究
DOI：
10.1016/j.jstrokecerebrovasdis.2020.105449
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发表时间：
2021
影响因子：
2.5
通讯作者：
Amimoto Kazu
中科院分区：
文献类型：
--
作者：
Fukata Kazuhiro;Fujino Yuji;Inoue Masahide;Inoue Mamiko;Sekine Daisuke;Tsutsumi Misato;Okihara Tetsuya;Mano Masayuki;Miki Hiroshi;Sato Hirofumi;Kobayashi Yohei;Hasegawa Koki;Kunieda Yota;Ishihara Shunichi;Makita Shigeru;Takahashi Hidetoshi;Amimoto Kazu
目的：卒中后急性期的坐位能力是反映功能结果的有用指标；然而，影响这一能力的因素尚未得到评估。因此，本研究旨在识别和评估影响卒中后急性期坐姿能力的因素。材料和方法：这项多中心前瞻性队列研究包括5家急诊医院接受急性卒中后住院康复计划的半球卒中患者。观察年龄、性别、患侧、病因、意识障碍、卒中及痴呆病史、卒中相关并发症、美国国立卫生研究院卒中量表评分、偏瘫、仰卧位翻身和仰卧起坐、对抗性推进量表在急性出院时修订版基本运动能力量表中“保持坐姿”项目上的影响。用二项Logistic回归分析确定影响坐位能力的因素。结果：我们纳入了293例中风患者。年龄(优势比：0.943，95%可信区间：0.910-0.977，p=0.001)、美国国立卫生研究院中风量表评分(优势比：0.862，95%可信区间：0.811-0.916，p<；0.001)和反推得分(优势比：0.543，95%可信区间：0.419-0.705，p<；0001)被确定为出院时坐着能力的独立预测因素(中位数；23.0天)。结论：高龄患者、反推高分患者和美国国立卫生研究院卒中评分高的患者在恢复坐位能力方面存在困难。这些结果对大脑半球卒中所致坐位能力受损患者的物理治疗具有指导意义。
Objectives:Sitting ability during the acute phase after stroke is a useful indicator of functional outcomes; however, factors that affect this ability have not been evaluated. Therefore, this study aimed to identify and evaluate factors that affect sitting ability in the acute phase after stroke.Materials and Methods:This multicenter prospective cohort study included hemispheric stroke patients who underwent an inpatient rehabilitation program after acute stroke from five acute care hospitals. The effect of age, sex, lesion side, etiology, consciousness disorder, stroke and dementia history, stroke-related complications, National Institutes of Health Stroke Scale score, hemiparalysis, turn-over movement from the supine position and sit-up movement, and Scale for Contraversive Pushing on the “remain sitting” item in the revised version of the Ability of Basic Movement Scale at the time of acute hospital discharge were investigated. Factors affecting sitting ability were identified using binomial logistic regression analysis.Results:We included 293 stroke patients. Age (odds ratio: 0.943, 95% confidence interval: 0.910–0.977,p=0.001), National Institutes of Health Stroke Scale score (odds ratio: 0.862, 95% confidence interval: 0.811–0.916,p<0.001), and Scale for Contraversive Pushing score (odds ratio: 0.543, 95% confidence interval: 0.419–0.705,p<0.001) were identified as independent predictors of sitting ability at the time of hospital discharge (median; 23.0 days).Conclusions:Older patients and those with high Scale for Contraversive Pushing and National Institutes of Health Stroke Scale scores experienced difficulties in regaining sitting ability. These results may guide physical therapy for patients with impaired sitting ability due to hemispheric stroke.