What Is the Longitudinal Profile of Impairments and Can We Predict Difficulty Caring for the Profoundly Affected Arm in the First Year Poststroke?
| Autor: | Siobhan Creanor, Jonathon Marsden, Cherry Kilbride, Ian Frampton, Rhoda Allison, Jade Chynoweth |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Time Factors Activities of daily living medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Shoulder Pain Activities of Daily Living Muscle Hypertonia Severity of illness Humans Medicine Longitudinal Studies Prospective Studies Spasticity Range of Motion Articular Prospective cohort study Stroke Aged Aged 80 and over Rehabilitation business.industry Incidence Stroke Rehabilitation Middle Aged medicine.disease Mood Muscle Spasticity Multivariate Analysis Arm Linear Models Physical therapy Female Contracture medicine.symptom 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 99:433-442 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2017.07.016 |
| Popis: | Objectives To establish the longitudinal profile of impairments of body functions and activity limitations of the arm, and to evaluate potential predictors of difficulty caring for the profoundly affected arm poststroke. Design Prospective cohort study. Setting Stroke services. Participants People unlikely to regain functional use of the arm (N=155) were recruited at 2 to 4 weeks poststroke, and followed up at 3, 6, and 12 months. Potential predictors at baseline were hypertonicity, pain, motor control, mood, sensation/perception, age, and stroke severity. Interventions Not applicable. Main Outcome Measures Difficulty caring for the arm (Leeds Arm Spasticity Impact Scale), pain, hypertonicity, range of movement, arm function, and skin integrity. Multivariable linear regression identified the best fitting model for predicting Leeds Arm Spasticity Impact Scale score at 12 months. Results There were 110 participants (71%) reviewed at 1 year. There was a large variation in the profile of arm functions and activity limitations. Inability or severe difficulty caring for the arm affected 29% of participants. Hypertonicity developed in 77%, with severe hypertonicity present in 25%. Pain was reported by 65%, 94% developed shoulder contracture, and 6% had macerated skin. Difficulty caring for the arm increased with age, greater level of hypertonicity, and stroke classification; collectively, these factors accounted for 33% of the variance in Leeds Arm Spasticity Impact Scale scores. Conclusions At 1 year poststroke, there was a high incidence of impairments of body functions and activity limitations in people with a profoundly affected arm. Individual profiles were very variable and although some predisposing factors have been identified, it remains difficult to predict who is at greatest risk. |
| Databáze: | OpenAIRE |
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