■确定哪些潜在的促成因素与获得性脑损伤(ABI)个体的上肢相关反应(AR)表达有关。
■42名参与者以自己选择的步行速度进行了三维运动分析,以生成AR结果度量,与健康对照相比,量化他们的上肢运动学偏差。临床评估包括:上肢和下肢高渗性,痉挛和力量,balance,动态行走稳定性,手臂和腿的功能,焦虑,手臂疼痛/不适,害怕跌倒。
■重要,上肢ARs与上肢肌肉和膝关节伸肌的高张力和痉挛之间存在中强相关性(r=0.42-0.74,p<0.05)。重要的,平衡与ARs存在中等相关性(r=0.42-0.59,p<0.05),动态稳定性,上肢力量,和手臂功能。AR的严重程度在有和没有四个测试的上肢肌肉的高渗性之间存在显着差异,肘部和长指屈肌痉挛,膝伸肌痉挛,动态稳定性降低(p<0.05;效应大小≥0.80)。然而,并非所有参与者都存在这些促成因素.
■相关反应是复杂的和多因素的。有几个显著的相关性表明因素可能影响AR严重程度。虽然上运动神经元综合征的阳性特征应优先用于临床评估,这些因素不是AR的先决条件。对康复的影响上肢相关反应是一种复杂的多因素现象。上肢肌肉高渗性和痉挛应优先进行评估;然而,它们不是相关反应的先决条件。应该区分高渗性和痉挛,因为它们可能与相关反应有不同的关系。膝关节伸肌张力过高和痉挛,姿势稳定性,上肢力量,手臂功能也可能是需要考虑的因素。
UNASSIGNED: To determine which potential contributing factors are associated with upper limb associated reaction (AR) expression in individuals with acquired brain injury (ABI).
UNASSIGNED: Forty-two participants underwent three-dimensional motion analysis at self-selected walking speed to generate the AR outcome measure, quantifying their upper limb kinematic deviation compared to healthy controls. Clinical assessment included: upper and lower limb
hypertonicity, spasticity and strength, balance, dynamic walking stability, arm and leg function, anxiety, arm pain/discomfort, and fear of falling.
UNASSIGNED: Significant, moderate-to-strong correlations (r = 0.42-0.74, p < 0.05) existed between upper limb ARs and both
hypertonicity and spasticity of the upper limb muscles and the knee extensors. Significant, moderate correlations to ARs (r = 0.42-0.59, p < 0.05) existed for balance, dynamic stability, upper limb strength, and arm function. The severity of AR was significantly different between those with and without
hypertonicity of the four tested upper limb muscles, elbow and long finger flexor spasticity, knee extensor spasticity, and reduced dynamic stability (p < 0.05; effect sizes ≥0.80). However, these contributing factors were not present in all participants.
UNASSIGNED: Associated reactions are complex and multi-factorial. There were several significant correlations indicating that factors may influence AR severity. While positive upper motor neuron syndrome features should be prioritised for clinical assessment, these factors are not prerequisites for ARs.IMPLICATIONS FOR REHABILITATIONUpper limb associated reactions are a complex and multi-factorial phenomenon.Upper limb muscle
hypertonicity and spasticity should be prioritised for assessment; however, they are not prerequisites for associated reactions.Hypertonicity and spasticity should be differentiated as they may have differing relationships to associated reactions.Knee extensor
hypertonicity and spasticity, postural stability, upper limb strength, and arm function may also be contributing factors to consider.