學院 |
醫學院 |
系所 |
職能治療學系 |
題名 |
Potential predictive values of
inflammatory biomarkers for stroke rehabilitation outcomes |
作者 |
Korivi, M., Wu, C-Y., & Lin, K-C.* |
期刊名稱 |
Journal of the Formosan Medical Association. (SCI 期刊) |
發表日期 |
2013 |
著作性質 |
原著 |
語文 |
英文 |
關鍵字 |
Biomarkers,
inflammation, oxidative stress, upper-limb, disabilities. |
摘要 |
Stroke
is the third leading cause of death, and a major contributor to permanent
disability among stroke survivors. Stroke-related disabilities are projected
to increase globally, with effects on the financial status of families and
national healthcare policies. Disabilities due to impaired motor functions,
particularly the hemiplegic upper extremity (UE), affects activities of daily
living (ADLs) and quality of life (QOL) in stroke survivors. Despite the
tremendous efforts devoted to stroke rehabilitation, a large number of stroke
survivors are still suffering with significant UE impairments. This fact
urges the need to develop effective treatment regimens and predictive models
of treatment outcomes using behavioral and biological markers. Knowledge
about how stroke outcomes are stratified is necessary for prognostication in
the early stages of stroke to rational planning of rehabilitation. The
Copenhagen Q4 Stroke Study measured the primary (death, discharge to nursing
home) and secondary (neurologic deficits, functional disabilities) outcomes
after rehabilitation, and results were used as a reliable tool for predicting
the risks of various outcomes in patients characterized by the initial degree
of stroke severity and/or functional disability. However, further research
on the prognosis of stroke recovery is necessary to shed light on the
possible mechanisms of change after stroke. Mounting evidence has demonstrated
that fluctuations in inflammatory biomarkers contribute to poor outcomes.
Activated inflammatory cells in brain increase the production of interleukins
(ILs), tumor necrosis factor-a, and highsensitivity C-reactive protein
(hs-CRP). Furthermore, stroke survivors have a greater prevalence of diabetes
that leads to severe oxidative stress, thus confining the benefits of
rehabilitation on these comorbidities. Knowledge in this area is still
insufficient; thus, studying the dynamics of inflammatory biomarkers during
rehabilitation is worthwhile to better understand the mechanism and also to
innovate the treatment protocols. |