不同年龄卒中亚急性期患者上肢感觉与运动功能的关系研究

目的 探讨不同年龄卒中亚急性期患者上肢感觉功能与运动功能的关系.方法 前瞻性选取2020年6-12月于上海市静安区中心医院、上海市第三康复医院、河南大学附属南石医院连续收治的卒中亚急性期存在单侧上肢功能障碍的患者.记录患者的临床资料,使用Semmes-Weinstein单丝和两点辨别觉测试工具分别评估上肢的触觉和两点辨...

Upper Limb Somatosensory Impairments in Subacute Stroke:Association with Upper Limb Motor Function and Age

Objective To investigate the association between upperlimb somatosensory impairment and motor function in subacute stroke patients of different ages.Methods This prospective study enrolled the poststroke patients in subacute phase who were consecutively admitted to Shanghai Jing’an District Central Hospital,Shanghai Third Rehabilitation Hospital,and Henan University Nanshi Hospital from June to December 2020.Semmes-Weinstein monofilaments(SWMs)and two-point discrimination instrument were used to evaluate the patient’s upper extremity tactile and two-point discrimination separately.Fugl-Meyer sensory scale was used to evaluate the patient’s upper limb tactile and proprioception.Fugl-Meyer Assessment-Upper Extremity Scale(FMA-UE)and Action Research Arm Test(ARAT)were used to evaluate upper limb motor.The patients were divided into the young and middle-aged group(18-59 years)and the elderly group(≥60 years).Bilateral sensory function between the two groups were compared,and the association between upper limb somatosensory function and motor function was analyzed.Results A total of 117 patients were included,with an average age of 61.1±11.7 years,and the average disease course of 40.0(22.0-61.5)days and 49 cases(41.9%)in young and middle-aged group and 68 cases(58.1%)in the elderly group.There was statistical difference in SWMs and twopoint discrimination of healthy upper limb between the two groups(both P<0.05).For all the stroke patients,the upper limb SWMs score was positively correlated with FMA-UE score and ARAT score(r values were 0.296 and 0.297,both P<0.01);Fugl-Meyer sensory function scale score was positively correlated with FMA-UE score and ARAT score(r values were 0.402 and 0.397,both P<0.01).For both groups,Fugl-Meyer sensory function scale score were positively correlated with FMA-UE score and ARAT score(r value in young and middle-aged group were 0.416 and 0.401,separately;the r value in the elderly group were 0.389 and 0.371,separately all P<0.01).Additionally,the upper limb SWMs score in the elderly group was positively correlated with FMA-UE score and ARAT score(r values were 0.330 and 0.365,separately,both P<0.01).Conclusions The upper limb tactile and proprioceptive sensations were positively correlated with motor function in subacute stroke patients.Age may have an impact on the association between tactile and motor function in the patients poststroke.