TY - T1的恢复和预测卒中后用双手的手使用JF -神经学乔-神经病学SP - e706 LP - e719做- 10.1212 / WNL。首页0000000000012366六世- 97 - 7盟盟珍妮特Plantin -马里昂Verneau盟艾莉森·k·Godbolt AU -盖亚瓦伦提娜Pennati盟Evaldas Laurencikas AU -贝·约翰逊盟莉娜Krumlinde-Sundholm AU -特里男爵盟Jorgen Borg AU -帕维尔·g·林德伯格Y1 - 2021/08/17 UR - //www.ez-admanager.com/content/97/7/e706.abstract N2 -目的确定复苏的主要预测因子的相似点和不同点用双手的手使用和unimanual卒中后运动障碍。首页方法前瞻性纵向研究,89年首次中风患者手臂麻痹性痴呆是评估在3周和中风发作后3个月和6个月。用双手的活动性能评估与成人协助评估中风(Ad-AHA),并与Fugl-Meyer unimanual运动损伤评估评估(FMA)。候选人预测因子包括肩绑架和手指扩展以相应的菲利普-马萨项(FMA-SAFE;范围0 - 4)和感官和认知障碍。MRI是用来测量加权皮质脊髓束损伤负载(wCST-LL)和静止状态两半球间的功能连通性(FC)。结果初始Ad-AHA性能很差但是改善随着时间的推移,在所有(mild-severe)损伤子组。Ad-AHA与菲利普-马萨在每个时间点(r比;0.88,p & lt;0.001),和恢复轨迹是相同的。中度到重度的患者最初的菲利普-马萨,FMA-SAFE得分是最强的预测Ad-AHA结果(R2 = 0.81)和程度的恢复(R2 = 0.64)。 Two-point discrimination explained additional variance in Ad-AHA outcome (R2 = 0.05). Repeated analyses without FMA-SAFE score identified wCST-LL and cognitive impairment as additional predictors. A wCST-LL >5.5 cm3 strongly predicted low to minimal FMA/Ad-AHA recovery (≤10 and 20 points respectively, specificity = 0.91). FC explained some additional variance to FMA-SAFE score only in unimanual recovery.Conclusion Although recovery of bimanual activity depends on the extent of corticospinal tract injury and initial sensory and cognitive impairments, FMA-SAFE score captures most of the variance explained by these mechanisms. FMA-SAFE score, a straightforward clinical measure, strongly predicts bimanual recovery.ClinicalTrials.gov Identifier NCT02878304.Classification of Evidence This study provides Class I evidence that the FMA-SAFE score predicts bimanual recovery after stroke.Ad-AHA=Adult Assisting Hand Assessment Stroke; BNIS=Barrow Neurological Institute Screen for Higher Cerebral Functions; CST=corticospinal tract; FC=functional connectivity; FMA=Fugl-Meyer Assessment; FMA-Hand=FMA for the hand; FMA-SAFE=FMA for shoulder abduction and finger extension; FMA-UE=FMA for the upper extremity; PCG=precentral gyrus; ROC=receiver operating characteristic; ROI=region of interest; SMA=supplementary motor area; 2pD=2-point discrimination; wCST-LL=weighted CST lesion load ER -
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