Abstract:

Objective To investigate the association between upperlimb somatosensory impairment and motor function in subacute stroke patients of different ages. Methods This prospective study enrolled the poststroke patients in subacute phase who were consecutively admitted to Shanghai Jing'an District Central Hospital, Shanghai Third Rehabilitation Hospital, and Henan University Nanshi Hospital from June to December 2020. Semmes-Weinstein monofilaments (SWMs) and two-point discrimination instrument were used to evaluate the patient’s upper extremity tactile and two-point discrimination separately. Fugl-Meyer sensory scale was used to evaluate the patient’s upper limb tactile and proprioception. Fugl-Meyer Assessment-Upper Extremity Scale (FMA-UE) and Action Research Arm Test (ARAT) were used to evaluate upper limb motor. The patients were divided into the young and middle-aged group (18-59 years) and the elderly group (≥60 years). Bilateral sensory function between the two groups were compared, and the association between upper limb somatosensory function and motor function was analyzed. Results A total of 117 patients were included, with an average age of 61.1±11.7 years, and the average disease course of 40.0 (22.0-61.5) days and 49 cases (41.9%) in young and middle-aged group and 68 cases (58.1%) in the elderly group. There was statistical difference in SWMs and twopoint discrimination of healthy upper limb between the two groups (both P <0.05). For all the stroke patients, the upper limb SWMs score was positively correlated with FMA-UE score and ARAT score (r values were 0.296 and 0.297, both P <0.01); Fugl-Meyer sensory function scale score was positively correlated with FMA-UE score and ARAT score (r values were 0.402 and 0.397, both P <0.01). For both groups, Fugl-Meyer sensory function scale score were positively correlated with FMA-UE score and ARAT score (r value in young and middle-aged group were 0.416 and 0.401, separately; the r value in the elderly group were 0.389 and 0.371, separately all P <0.01). Additionally, the upper limb SWMs score in the elderly group was positively correlated with FMA-UE score and ARAT score (r values were 0.330 and 0.365, separately, both P <0.01). Conclusions The upper limb tactile and proprioceptive sensations were positively correlated with motor function in subacute stroke patients. Age may have an impact on the association between tactile and motor function in the patients poststroke.

Key words: Stroke; Somatosensory function; Motor function; Age

摘要：

目的 探讨不同年龄卒中亚急性期患者上肢感觉功能与运动功能的关系。 方法 前瞻性选取2020年6-12月于上海市静安区中心医院、上海市第三康复医院、河南大学附属南 石医院连续收治的卒中亚急性期存在单侧上肢功能障碍的患者。记录患者的临床资料，使用Semmes- Weinstein单丝和两点辨别觉测试工具分别评估上肢的触觉和两点辨别觉，Fugl-Meyer感觉量表综合 评估患者上肢和手的触觉、本体感觉，Fugl -Meyer上肢运动功能评定（Fugl -Meyer assessment upper extremity，FMA-UE）和上肢动作研究测试（action research arm test，ARAT）量表评估患者的上肢运动 功能。将患者分为青中年组（18～59岁）和老年组（≥60岁），比较两组患者双侧上肢感觉功能差异， 分析总体及不同年龄组患者上肢感觉功能与运动功能的相关性。 结果 共纳入117例患者，平均年龄61.1±11.7岁，卒中病程平均40.0（22.0～61.5）d。青中年组患者 49例（41.9%），老年组患者68例（58.1%）。两组患者健侧上肢Semmes-Weinstein单丝触觉评分和两 点辨别觉差异具有统计学意义（均P＜0.05）。卒中患者上肢Semmes-Weinstein单丝触觉评分与FMA-UE 评分及ARAT评分呈弱正相关（r值分别为0.296和0.297，均P＜0.01）；Fugl -Meyer感觉功能量表评分与 FMA-UE评分及ARAT评分呈正相关（r值分别为0.402和0.397，均P＜0.01）。两组患者的Fugl-Meyer感觉 功能量表评分均与FMA-UE评分及ARAT评分呈正相关（青中年组r值分别为0.416和0.401，老年组r值 分别为0.389和0.371，均P＜0.01）；老年组患者的上肢Semmes-Weinstein单丝触觉评分与FMA-UE评分及 ARAT评分呈正相关（r值分别为0.330和0.365，均P＜0.01）。 结论 卒中亚急性期患者上肢触觉和本体感觉与运动功能呈正相关。年龄对卒中亚急性期患者上 肢触觉与运动功能的相关性可能存在影响。

关键词: 卒中; 感觉功能; 运动功能; 年龄