Yamamoto Haruka, Takeda Kazuya, Koyama Soichiro, Morishima Keisuke, Hirakawa Yuichi, Motoya Ikuo, Sakurai Hiroaki, Kanada Yoshikiyo, Kawamura Nobutoshi, Kawamura Mami, Tanabe Shigeo
Department of Rehabilitation, Kawamura Hospital, Gifu, Japan.
Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
Br J Occup Ther. 2022 May;85(5):360-366. doi: 10.1177/03080226211030088. Epub 2021 Sep 26.
Upper limb motor function and activities of daily living (ADL) are related in chronic stroke patients. This study investigated this relationship after removal of the influence of motor function of the affected lower limb, which until now has remained unclear.
This retrospective cross-sectional study included 53 patients with chronic stroke. Upper and lower limb motor function and ADL were assessed using the Fugl-Meyer assessment of the upper (FMA-UL) and lower limbs (FMA-LL) and functional independence measure motor score (FIM-M). To clarify the relationship between FMA-UL and total FIM-M before and after removal of the influence of FMA-LL, Spearman's rank correlation coefficient and partial correlation analysis were used. The relationship between FMA-UL and each item of FIM-M after removal of the influence of FMA-LL was assessed using partial correlation analysis.
Before the influence of FMA-LL was removed, FMA-UL was moderately to well correlated with total FIM-M. This became weak after the influence was removed. Regarding each item of FIM-M, FMA-UL was correlated with dressing (upper body), toileting, and walking or wheelchair after removal of the influence.
The relationship between upper limb motor function and ADL is strongly influenced by lower limb motor function.
慢性中风患者的上肢运动功能与日常生活活动(ADL)相关。本研究在排除患侧下肢运动功能影响后,对这种关系进行了调查,而此前这种关系一直不明确。
这项回顾性横断面研究纳入了53例慢性中风患者。使用上肢Fugl-Meyer评估量表(FMA-UL)和下肢Fugl-Meyer评估量表(FMA-LL)以及功能独立性测量运动评分(FIM-M)对上肢和下肢运动功能及ADL进行评估。为了阐明在排除FMA-LL影响前后FMA-UL与总FIM-M之间的关系,采用了Spearman等级相关系数和偏相关分析。使用偏相关分析评估在排除FMA-LL影响后FMA-UL与FIM-M各项目之间的关系。
在排除FMA-LL影响之前,FMA-UL与总FIM-M呈中度至高度相关。排除影响后这种相关性变弱。关于FIM-M的各项目,在排除影响后,FMA-UL与穿衣(上身)、 toileting以及行走或轮椅使用相关。
上肢运动功能与ADL之间的关系受下肢运动功能的强烈影响。