Time to Recovery From Lateropulsion Dependent on Key Stroke Deficits: A Retrospective Analysis
Time to Recovery From Lateropulsion Dependent on Key Stroke Deficits: A Retrospective Analysis
复制标题
DOI：
10.1177/1545968314541330
复制
发表时间：
2015-03-01
影响因子：
4.2
通讯作者：
Reding, Michael
中科院分区：
文献类型：
--
作者：
Babyar, Suzanne R.;Peterson, Margaret G. E.;Reding, Michael
背景。侧推，一种姿势控制障碍，延迟半脑卒中后的恢复。脑卒中损伤的数量可能导致不同的恢复率，这取决于可用于侧推伤恢复的完整系统。目标。目的：研究脑卒中后关键姿势控制缺陷对侧推恢复率的影响。方法。回顾性分析：169例半脑卒中住院康复患者分为3组：(1)单纯运动障碍患者；(2)运动和偏视或视觉空间缺陷或运动和本体感觉缺陷；(3)运动、本体感觉、偏视或视觉空间缺陷。Kaplan-Meier生存分析确定各组从侧裂恢复的时间（在Burke侧裂量表中得分为0或1）是否不同。结果。对数秩检验显示，侧裂恢复所需的时间因缺陷数量的不同而不同（组，P = 0.012）。病变侧的事后分析显示，与左脑病变（P = .34）相比，仅右脑病变出现组间差异（P < 0.05）。只有运动障碍的患者可在住院康复期间从侧撕脱中恢复；所有三种姿势控制缺陷的患者恢复时间最长。结论。脑卒中后侧推的恢复率取决于病变部位、关键运动、本体感觉和/或偏视或视觉空间缺陷的数量。姿势控制系统受影响越多，恢复就越慢。我们的数据确定了可能需要针对关键姿势控制缺陷进行长期康复的患者。
Background. Lateropulsion, a postural control disorder, delays recovery following hemispheric stroke. The number of stroke impairments may lead to differential recovery rates, depending on the intact systems available for recovery from lateropulsion. Objective. To study the impact of key postural control deficits on lateropulsion rate of recovery following stroke. Methods. Through retrospective analysis: 169 patients with hemispheric stroke in an in-patient rehabilitation facility were divided into 3 groups: (1) motor deficits only; (2) motor and hemianopic or visual-spatial deficits or motor and proprioceptive deficits; and (3) motor, proprioceptive, and hemianopic or visual-spatial deficits. Kaplan-Meier survival analysis determined if time to recovery from lateropulsion (achieving a score of 0 or 1 on the Burke Lateropulsion Scale) differed by group. Results. Log rank tests showed that time to recovery from lateropulsion differed based on the number of deficits (group, P = .012). Post hoc analyses by lesion side showed that group differences only occurred in right brain lesion (P < .05) as compared with left brain lesions (P = .34). Patients recovered from lateropulsion during in-patient rehabilitation if they had only motor deficits; those with all 3 postural control deficits showed the most protracted recovery. Conclusions. Rate of recovery from lateropulsion after stroke is dependent on the side of lesion, and number of key motor, proprioceptive, and/or hemianopic or visual-spatial deficits. The more postural control systems affected, the slower the recovery. Our data identify patients likely to need protracted rehabilitation targeting key postural control deficits.