學院 |
醫學院 |
系所 |
職能治療學系 |
題名 |
Proximal Fugl-Meyer Assessment scores predict clinically important upper limb improvement after three stroke rehabilitative interventions |
作者 |
Lee, Y-Y.,
Hsieh, Y-W., Wu, C-Y., Lin, K-C.*,
& Chen, C-K. |
期刊名稱 |
Archives of Physical Medicine and Rehabilitation |
發表日期 |
2015 |
著作性質 |
原著 |
語文 |
英文 |
關鍵字 |
Stroke,
Rehabilitation, Predictors, Responders, Fugl-Meyer Assessment |
摘要 |
Background: Determining appropriate
rehabilitation approaches for individuals after stroke has been a challenge
for clinicians. Objective: This study aimed to
identify the baseline motor characteristics of the patients who responded to
3 prominent intervention programs. Design: A secondary analysis
from clinical trials was conducted. Methods:
The
study analyzed 174 individuals with chronic stroke who received interventions
based on constraint-induced movement therapy (CIMT), robot-assisted therapy
(RT), or mirror therapy (MT). The primary outcome measure was the change
score of the upper-extremity Fugl-Meyer Assessment (UE-FMA). The potential
predicting variables were baseline proximal, distal, and total UE-FMA, and Action Research Arm Test (ARAT) scores. We combined
polynomial regression analyses and the minimal clinically important
difference to stratify the patients as responders and non-responders for each
intervention approach. Results:
The
baseline proximal UE-FMA significantly predicted clinically important
improvement on the primary outcome after all 3 interventions. Participants
with baseline proximal UE-FMA scores approximately <30 benefited
significantly from CIMT and RT, whereas participants with scores between 21
and 35 demonstrated significant improvements after MT. Baseline distal and
total UE-FMA and ARAT scores could also predict upper limb improvements after
CIMT and MT but not after RT. Limitations: Participants with
very low or high baseline UE-FMA scores were not recruited, which may limit
interpretations of the results. Generality of the current findings needs
further validation. Conclusion:
This
study could inform clinicians about the selection of suitable rehabilitation
approaches to help patients achieve clinically meaningful improvements in
upper extremity function. |