Predictors of upper limb recovery after stroke: a systematic review and meta-analysis
Predictors of upper limb recovery after stroke: a systematic review and meta-analysis
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DOI：
10.1177/0269215511420305
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发表时间：
2012-04-01
影响因子：
3
通讯作者：
Langhorne, Peter
中科院分区：
文献类型：
--
作者：
Coupar, Fiona;Pollock, Alex;Langhorne, Peter
目的：系统地回顾和总结目前有关卒中后上肢功能恢复的预后变量的文献。数据来源：我们在MEDLINE、EMBASE、AMED、CINAHL和科克伦中心数据库中完成了检索。研究方法：纳入基线时测量的预测变量，并与未来某个时间点上肢康复结果相关的研究。排除标准包括与治疗反应相关的预测变量和非常特殊的上肢损伤（如痉挛或疼痛）的结局测量。两名独立的评论员完成了数据提取和评估研究quality. Results：58项研究符合纳入标准。这些研究中考虑的预测变量包括：年龄、性别、病变部位、初始运动障碍、运动诱发电位和体感诱发电位。上肢损伤和功能的初始测量被发现是上肢恢复的最重要预测因素;比值比为14.84（95%置信区间（CI）9.08 - 24.25）和38.62（95% CI 8.40 - 177.53）。这些结果的解释是复杂的方法学因素，包括研究人群的变化，上肢运动结果量表，基线和结局评估的时间安排以及选定的预测因素。中风后上肢恢复最重要的预测因素似乎是运动障碍或功能的初始严重程度。
Objective: To systematically review and summarize the current available literature on prognostic variables relating to upper limb recovery following stroke. To identify which, if any variables predict upper limb recovery following stroke.Data sources: We completed searches in MEDLINE, EMBASE, AMED, CINAHL and Cochrane CENTRAL databases. Searches were completed in November 2010.Review methods: Studies were included if predictor variables were measured at baseline and linked to an outcome of upper limb recovery at a future time point. Exclusion criteria included predictor variables relating to response to treatment and outcome measurements of very specific upper limb impairments such as spasticity or pain. Two independent reviewers completed data extraction and assessed study quality.Results: Fifty-eight studies met the inclusion criteria. Predictor variables which have been considered within these studies include; age, sex, lesion site, initial motor impairment, motor-evoked potentials and somatosensory-evoked potentials. Initial measures of upper limb impairment and function were found to be the most significant predictors of upper limb recovery; odds ratio 14.84 (95% confidence intervals (CI) 9.08-24.25) and 38.62 (95% CI 8.40-177.53), respectively.Conclusions: Interpretation of these results is complicated by methodological factors including variations in study populations, upper limb motor outcome scales, timing of baseline and outcome assessments and predictors selected. The most important predictive factors for upper limb recovery following stroke appears to the initial severity of motor impairment or function.