PDF(Pubmed)
Abstract：
BACKGROUND: Tetraplegia is a debilitating sequela of spinal cord injury (SCI). However, comprehensive approaches for determining the influence of various factors on activities of daily living (ADL) in patients with tetraplegia are limited. Therefore, this study aimed to determine the influence of physical factors on ADL in patients with tetraplegia after adjusting for demographic, SCI-related, and cognitive factors.
METHODS: This retrospective cross-sectional study enrolled 201 patients with tetraplegia who underwent inpatient rehabilitation at the National Rehabilitation Center in South Korea between 2019 and 2021. Patients\' mean age was 50.5 years (standard deviation, 16.3), and 170 (84.6%) were men. The Korean Spinal Cord Independence Measure III (K-SCIM III) was used as the main outcome measure to assess patients\' ADL ability. Hierarchical multiple regression modeling was conducted with K-SCIM as the dependent variable to examine the level of functioning and relative influencing factors.
RESULTS: Upper-extremity motor score (UEMS), upper-extremity spasticity and sitting balance scores were significant predictors of self-care; lower-extremity motor score (LEMS), musculoskeletal pain of shoulder, and sitting balance were significant predictors of respiratory and sphincter management; UEMS, LEMS, and sitting balance score were significant predictors of mobility; and UEMS, LEMS, musculoskeletal pain of shoulder, and sitting balance scores were significant predictors of the K-SCIM III total score after adjustment for demographic, SCI-related, and cognitive factors.
CONCLUSIONS: Physical factors had the greatest impact on all subscores and the K-SCIM III total score. Upper- and lower-extremity muscle strength and sitting balance significantly affected functional ability across all subscores.
METHODS: This retrospective cross-sectional study enrolled 201 patients with tetraplegia who underwent inpatient rehabilitation at the National Rehabilitation Center in South Korea between 2019 and 2021. Patients\' mean age was 50.5 years (standard deviation, 16.3), and 170 (84.6%) were men. The Korean Spinal Cord Independence Measure III (K-SCIM III) was used as the main outcome measure to assess patients\' ADL ability. Hierarchical multiple regression modeling was conducted with K-SCIM as the dependent variable to examine the level of functioning and relative influencing factors.
RESULTS: Upper-extremity motor score (UEMS), upper-extremity spasticity and sitting balance scores were significant predictors of self-care; lower-extremity motor score (LEMS), musculoskeletal pain of shoulder, and sitting balance were significant predictors of respiratory and sphincter management; UEMS, LEMS, and sitting balance score were significant predictors of mobility; and UEMS, LEMS, musculoskeletal pain of shoulder, and sitting balance scores were significant predictors of the K-SCIM III total score after adjustment for demographic, SCI-related, and cognitive factors.
CONCLUSIONS: Physical factors had the greatest impact on all subscores and the K-SCIM III total score. Upper- and lower-extremity muscle strength and sitting balance significantly affected functional ability across all subscores.
摘要：
背景：四肢瘫痪是脊髓损伤（SCI）的衰弱后遗症。然而,确定各种因素对四肢瘫痪患者日常生活活动（ADL）影响的综合方法有限。因此,这项研究的目的是确定身体因素对四肢瘫痪患者ADL的影响，SCI相关,和认知因素。
方法：这项回顾性横断面研究纳入了201名四肢瘫痪患者，他们在2019年至2021年期间在韩国国家康复中心接受了住院康复治疗。患者的平均年龄为50.5岁(标准差，16.3),男性有170人(84.6%)。使用韩国脊髓独立性措施III（K-SCIMIII）作为评估患者ADL能力的主要结果指标。以K-SCIM为因变量进行分层多元回归建模,考察功能水平及相关影响因素。
结果：上肢运动评分（UEMS），上肢痉挛和坐姿平衡评分是自我护理的显著预测因子;下肢运动评分(LEMS),肩部肌肉骨骼疼痛，和坐姿平衡是呼吸和括约肌管理的重要预测因子；UEMS，LEMS,坐姿平衡分数是行动不便的重要预测因子；UEMS，LEMS,肩部肌肉骨骼疼痛，和坐姿平衡分数是调整人口统计学后K-SCIMIII总分的重要预测因子，SCI相关,和认知因素。
结论：物理因素对所有子评分和K-SCIMIII总分的影响最大。上肢和下肢肌肉力量和坐姿平衡显着影响所有子得分的功能能力。
方法：这项回顾性横断面研究纳入了201名四肢瘫痪患者，他们在2019年至2021年期间在韩国国家康复中心接受了住院康复治疗。患者的平均年龄为50.5岁(标准差，16.3),男性有170人(84.6%)。使用韩国脊髓独立性措施III（K-SCIMIII）作为评估患者ADL能力的主要结果指标。以K-SCIM为因变量进行分层多元回归建模,考察功能水平及相关影响因素。
结果：上肢运动评分（UEMS），上肢痉挛和坐姿平衡评分是自我护理的显著预测因子;下肢运动评分(LEMS),肩部肌肉骨骼疼痛，和坐姿平衡是呼吸和括约肌管理的重要预测因子；UEMS，LEMS,坐姿平衡分数是行动不便的重要预测因子；UEMS，LEMS,肩部肌肉骨骼疼痛，和坐姿平衡分数是调整人口统计学后K-SCIMIII总分的重要预测因子，SCI相关,和认知因素。
结论：物理因素对所有子评分和K-SCIMIII总分的影响最大。上肢和下肢肌肉力量和坐姿平衡显着影响所有子得分的功能能力。
