A Preliminary Evaluation on the Correlation between Severity of Hand Spasticity and Functional Recovery in Chronic Stroke Patients

慢性中風患者手部痙攣嚴重度與功能性恢復的相關性探討

10.6315/2015.43(3)05

徐宛伶(Wan-Ling Hsu)；連一潔(Yi-Chieh Lien)；張維修(Wei-Hsiu Chang)；馮紀慈(Chi-Tzu Feng)；周桂酉(Kuei-Yu Chou)；蕭安芳(An-Fang Hsiao)

相關性 ； 慢性中風患者 ； 手部痙攣 ； 改良式艾斯渥氏量表 ； 功能性恢復 ； correlation ； chronic stroke patients ； hand spasticity ； Modified Ashworth Scale ； functional recovery

台灣復健醫學雜誌

43卷3期（2015 / 09 / 01）

181 - 189

英文

本研究為再次分析之研究，目的為探討慢性中風患者手部痙攣問題與其功能性恢復的相關性。分析之樣本為21位慢性中風患者，且接受過手部拉筋設備或功能性活動之訓練；手部痙攣使用改良式艾斯渥氏量表來評量，而功能性恢復則使用傅格－梅爾評估量表、手臂動作調查測試表、功能獨立量表、中風影響量表等工具，並利用相關性分析來探討兩者的相關性。結果顯示改良式艾斯渥氏量表與功能獨立量表有顯著相關(p=.029)，但因本研究參與者的年齡與痙攣程度有所偏頗，可能會影響此結果之呈現；且痙攣問題有所改善之個案其功能性恢復評量並無明顯的相關性呈現，即使僅有輕微痙攣問題之患者於介入後有較明顯的進步。由上述結果可知，雖然當個案有較低的手部痙攣表現時，較能於介入後得到功能性的恢復，但受限於本研究未納入各痙攣程度之個案，慢性中風患者之手部痙攣嚴重度與功能性恢復的相關性分析卻不甚顯著，需要未來更多的研究才能真正了解兩者的相關性。

Objective: This study is a secondary analysis of data from a previous project that attempts to analyze the correlation between severity of hand spasticity and functional recovery in chronic stroke patients. Methods: A total of 21 chronic stroke patients who received hand-stretching device or functional training were analyzed. The evaluation of outcomes included the Modified Ashworth Scale (MAS) for assessing hand spasticity; Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), the Functional Independence Measure (FIM), and Stoke Impact Scale (SIS) for evaluating functional recovery. Results: Correlation was found between MAS and FIM scores (p=.029), but due to bias on age and severity of spasticity, we could not confirm that hand MAS correlated with activity of daily living (ADL). We also found a limited relationship between change in severity of hand spasticity and functional recovery, even in subjects with lower MAS scores who showed greater improvement in the post-test. Conclusion: Although subjects with low hand spasticity benefited more from the intervention, we found limited correlation between hand spasticity and functional recovery. Further studies to clarify this actual correlation are required.