Disparity Between Functional Recovery and Daily Use of the Upper and Lower Extremities During Subacute Stroke Rehabilitation
Disparity Between Functional Recovery and Daily Use of the Upper and Lower Extremities During Subacute Stroke Rehabilitation
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DOI：
10.1177/1545968311408918
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发表时间：
2012-01-01
影响因子：
4.2
通讯作者：
Eng, Janice J.
中科院分区：
文献类型：
--
作者：
Rand, Debbie;Eng, Janice J.
背景虽然住院康复可以提高中风后个体的功能能力，但尚不清楚这些改善是否伴随着手臂和腿部日常使用的增加。目标.确定脑卒中患者在康复期间上肢和下肢日常使用的变化，并将这些值与社区居住的老年人进行比较。方法.共有60名中风患者接受了功能评估，并在入院康复时和出院前3周连续3个工作日佩戴3个加速度计。在清醒时间和日常使用期间测量步数和上肢活动计数，以进行职业治疗（OT）和物理治疗（PT）。健康老年人（n = 40）也连续5天佩戴3个加速度计。结果中风患者表现出活动功能的显著增加，这伴随着全天的每日步行以及PT的增加。然而，每日步行的增加主要见于入院时使用轮椅的患者（而不是步行者）。对照组步行值（5202步）是中风患者的17倍多。尽管麻痹性手功能有显著改善，但在全天或PT中未发现麻痹性手或非麻痹性手的日常使用增加。结论.在住院脑卒中康复期间，发现功能恢复与上肢和下肢日常使用增加之间存在差异。
Background. Although inpatient rehabilitation may enhance an individual's functional ability after stroke, it is not known whether these improvements are accompanied by an increase in daily use of the arms and legs. Objectives. To determine the change in daily use of the upper and lower extremities of stroke patients during rehabilitation and to compare these values with that of community-dwelling older adults. Methods. A total of 60 stroke patients underwent functional assessments and also wore 3 accelerometers for 3 consecutive weekdays on admission to rehabilitation and 3 weeks later prior to hospital discharge. The number of steps and upper-extremity activity counts were measured over the waking hours and during daily use for occupational therapy (OT) and physical therapy (PT) sessions. Healthy older adults (n = 40) also wore 3 accelerometers for 5 consecutive days. Results. Stroke patients demonstrated a significant increase in mobility function, and this was accompanied by an increase in daily walking over the entire day as well as in PT. However, increases in daily walking were found predominantly in patients who were wheelchair users (and not walkers) at the time of admission. Control walking values (5202 steps) were more than 17 times that of stroke patients. Despite significant improvements in paretic hand function, no increase in daily use of the paretic or nonparetic hand was found over the entire day or in PT. Conclusions. A disparity between functional recovery and increases in daily use of the upper and lower extremities was found during inpatient stroke rehabilitation.