RT期刊文章SR电子T1恢复和预测卒中后用双手的手使用摩根富林明神经病学神经学乔FD Lippincott Williams &威尔金斯SP e706 OP e719 10.1212 / WNL首页。97签证官0000000000012366是7 A1珍妮特Plantin A1马里昂Verneau A1艾莉森·k·Godbolt A1盖亚瓦伦蒂娜Pennati A1 Evaldas Laurencikas A1 Birgitta约翰逊A1莉娜Krumlinde-Sundholm A1特里男爵A1 (Jorgen Borg A1帕维尔·g·林德伯格年2021 UL //www.ez-admanager.com/content/97/7/e706.abstract AB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首页手使用和unimanual卒中后运动障碍。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。在每个时间点Ad-AHA与菲利普-马萨(r > 0.88, p < 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)。两点歧视额外解释方差Ad-AHA结果(R2 = 0.05)。重复分析没有FMA-SAFE分数确认wCST-LL和认知障碍是额外的预测因子。 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
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