中風病人早期患側上肢動作能力與半年後手部功能恢復程度的相關性

The Relationship between Early Motor Stage and hand Function Recovery Six Months after Stroke

張志仲(Jyh-Jong Chang) ； 宋雲通(Yue-Tung Sung) ； 林永哲(Young-Tso Lin)

《The Kaohsiung Journal of Medical Sciences》 6卷1期 (1990/01) Pp. 38-44

https://doi.org/10.6452/KJMS.199001.0038

摘要

The prognosis of hemiplegic hand func-tion may reflect intrinsic recovery. Applying the variables of initial neurological loss in the hemiplegic upper extremity to predict the prognosis of hand function will enable thera-pists to establish the ultimate goals of reha-bilitation and to select the appropriate treat-ment programs.
Pinch and grip strength tests, Frenchay arm function test and the nine- hole peg test were used to determine the relationship be-tween the initial Brunnstrom motor stage of the hemiplegic upper extremity and the prognosis of hand function after six months. Forty stroke patients were divided into three groups. Group I was subjects with a motor stage below the Brunnstrom motor stage III in both proximal and distal parts of the hemi-plegic upper extremity. Group II was subjects with motor stage below Brunnstrom motor stage III in the proximal part and above stage III in the distal part or vice versa. Group III was subjects with a motor stage above Brunnstrom motor stage III both in the proxi-mal and the distal parts. The results of this study indicated that the prognosis of the Brunnstrom motor stage of the hemiplegic upper extremity generally improved about one or two stages. According to the results of the grip and pinch strength tests, the Frenchay arm function test or the nine-hole peg test, group I patients could hardly use their affect-ed hand functionally. The grip strength and the pinch strength deficits of group I were 93.8% and 91.4% respectively. The grip strength and the pinch strength deficits of group II were 72.1% and 68.5% respectively. The group III patients could potentially reach a normal range in pinch, grip strength tests, and the Frenchay arm function test, but would have 27% deficits in the nine-hole peg test.
This study suggests that the early Brunn-strom motor stage can be a useful prediction tool for the prognosis of hand function after six months in stroke patients. The results also can serve as a good reference for the occupa-tional therapist in setting the ultimate goals of rehabilitation and treatment programs for stroke patients.

並列摘要

The prognosis of hemiplegic hand func-tion may reflect intrinsic recovery. Applying the variables of initial neurological loss in the hemiplegic upper extremity to predict the prognosis of hand function will enable thera-pists to establish the ultimate goals of reha-bilitation and to select the appropriate treat-ment programs.
Pinch and grip strength tests, Frenchay arm function test and the nine- hole peg test were used to determine the relationship be-tween the initial Brunnstrom motor stage of the hemiplegic upper extremity and the prognosis of hand function after six months. Forty stroke patients were divided into three groups. Group I was subjects with a motor stage below the Brunnstrom motor stage III in both proximal and distal parts of the hemi-plegic upper extremity. Group II was subjects with motor stage below Brunnstrom motor stage III in the proximal part and above stage III in the distal part or vice versa. Group III was subjects with a motor stage above Brunnstrom motor stage III both in the proxi-mal and the distal parts. The results of this study indicated that the prognosis of the Brunnstrom motor stage of the hemiplegic upper extremity generally improved about one or two stages. According to the results of the grip and pinch strength tests, the Frenchay arm function test or the nine-hole peg test, group I patients could hardly use their affect-ed hand functionally. The grip strength and the pinch strength deficits of group I were 93.8% and 91.4% respectively. The grip strength and the pinch strength deficits of group II were 72.1% and 68.5% respectively. The group III patients could potentially reach a normal range in pinch, grip strength tests, and the Frenchay arm function test, but would have 27% deficits in the nine-hole peg test.
This study suggests that the early Brunn-strom motor stage can be a useful prediction tool for the prognosis of hand function after six months in stroke patients. The results also can serve as a good reference for the occupa-tional therapist in setting the ultimate goals of rehabilitation and treatment programs for stroke patients.

並列關鍵字

hemiplegia ； motor recovery ； hand function