Transcranial Motor Evoked Potentials of Lower Limbs Can Prognosticate Ambulation in Hemiplegic Stroke Patients
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To examine the association between motor evoked potentials (MEPs) in lower limbs and ambulatory outcomes of hemiplegic stroke patients.Methods Medical records of hemiplegic patients with the first ever stroke who received inpatient rehabilitation from January 2013 to May 2014 were reviewed. Patient who had diabetes, quadriplegia, bilateral lesion, brainstem lesion, severe musculoskeletal problem, and old age over 80 years were excluded. MEPs in lower limbs were measured when they were transferred to the Department of Rehabilitation Medicine. Subjects were categorized into three groups (normal, abnormal, and absent response) according to MEPs findings. Berg Balance Scale (BBS) and Functional Ambulation Category (FAC) at initial and discharge were compared among the three groups by one-way analysis of variance (ANOVA). Correlation was determined using a linear regression model.Results Fifty-eight hemiplegic patients were included. BBS and FAC at discharge were significantly (ANOVA, p<0.001) different according to MEPs findings. In linear regression model of BBS and FAC using stepwise selection, patients’ age (p<0.01), BBS at admission (p<0.01), and MEPs (p<0.01) remained significant covariates. In regression assumption model of BBS and FAC at admission, MEPs and gender were significant covariates.Conclusion Initial MEPs of lower limbs can prognosticate the ambulatory outcomes of hemiplegic patients.
Abstract
Objective To examine the association between motor evoked potentials (MEPs) in lower limbs and ambulatory outcomes of hemiplegic stroke patients.Methods Medical records of hemiplegic patients with the first ever stroke who received inpatient rehabilitation from January 2013 to May 2014 were reviewed. Patient who had diabetes, quadriplegia, bilateral lesion, brainstem lesion, severe musculoskeletal problem, and old age over 80 years were excluded. MEPs in lower limbs were measured when they were transferred to the Department of Rehabilitation Medicine. Subjects were categorized into three groups (normal, abnormal, and absent response) according to MEPs findings. Berg Balance Scale (BBS) and Functional Ambulation Category (FAC) at initial and discharge were compared among the three groups by one-way analysis of variance (ANOVA). Correlation was determined using a linear regression model.Results Fifty-eight hemiplegic patients were included. BBS and FAC at discharge were significantly (ANOVA, p<0.001) different according to MEPs findings. In linear regression model of BBS and FAC using stepwise selection, patients’ age (p<0.01), BBS at admission (p<0.01), and MEPs (p<0.01) remained significant covariates. In regression assumption model of BBS and FAC at admission, MEPs and gender were significant covariates.Conclusion Initial MEPs of lower limbs can prognosticate the ambulatory outcomes of hemiplegic patients.
참고문헌 (26)
- Baer HR, "Modified emory functional ambulation profile: an outcome measure for the rehabilitation of poststroke gait dysfunction", Stroke, 32, pp.973~979 (2001)
- Perry J, "Classification of walking handicap in the stroke population", Stroke, 26, pp.982~989 (1995)
- Escudero JV, "Prognostic value of motor evoked potential obtained by transcranial magnetic brain stimulation in motor function recovery in patients with acute ischemic stroke", Stroke, 29, pp.1854~1859 (1998)
- Rapisarda G, "Can motor recovery in stroke patients be predicted by early transcranial magnetic stimulation?", Stroke, 27, pp.2191~2196 (1996)
- Heald A, "Longitudinal study of central motor conduction time following stroke. 2. Central motor conduction measured within 72 h after stroke as a predictor of functional outcome at 12 months", Brain, 116(Pt 6), pp.1371~1385 (1993)
- Kang MJ, "Motor evoked potential in stroke", J Korean Acad Rehabil Med, 17, pp.26~35 (1993)
- 강동화, "급성기 뇌경색 환자에서 초기 경두개 자기자극 검사의 아급성기 운동기능 회복에 대한 예측", 대한뇌졸중학회지, 2(1), pp.57~61 (2000), 대한뇌졸중학회
- Kim C, "The significance of motor evoked potentials as a prognostic factor in the early stage of stroke patients", J Korean Acad Rehabil Med, 23, pp.1213~1220 (1999)
- Han TR, "Motor evoked potentials of upper and lower extremities by magnetic stimulation in hemiparesis", J Korean Acad Rehabil Med, 22, pp.386~391 (1998)
- 정한영, "뇌졸중 환자에서 NIHSS 검사와 운동유발전위와의 연관관계", Annals of Rehabilitation Medicine, 29(6), pp.563~567 (2005), 대한재활의학회
- Rossini PM, "Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application. Report of an IFCN committee", Electroencephalogr Clin Neurophysiol, 91, pp.79~92 (1994)
- Lee RG, "Mechanisms underlying functional recovery following stroke", Can J Neurol Sci, 22, pp.257~263 (1995)
- Allen CM, "Predicting the outcome of acute stroke: a prognostic score", J Neurol Neurosurg Psychiatry, 47, pp.475~480 (1984)
- Anderson TP, "Studies up to 1980 on stroke rehabilitation outcomes", Stroke, 21(9 Suppl), pp.II43~II45 (1990)
- Barker AT, "An introduction to the basic principles of magnetic nerve stimulation", J Clin Neurophysiol, 8, pp.26~37 (1991)
- D’Olhaberriague L, "Transcranial magnetic stimulation as a prognostic tool in stroke", J Neurol Sci, 147, pp.73~80 (1997)
- Macdonell RA, "A comparison of somatosensory evoked and motor evoked potentials in stroke", Ann Neurol, 25, pp.68~73 (1989)
- Eisen AA, "AAEM minimonograph #35:Clinical experience with transcranial magnetic stimulation", Muscle Nerve, 13, pp.995~1011 (1990)
- Lawrence RR, "Electrodiagnostic medicine", pp.415~427 (2002), Hanley & Belfus
- Smith PS, "Berg balance scale and functional reach: determining the best clinical tool for individuals post acute stroke", Clin Rehabil, 18, pp.811~818 (2004)
- Blum L, "Usefulness of the Berg balance scale in stroke rehabilitation: a systematic review", Phys Ther, 88, pp.559~566 (2008)
- Viosca E, "Proposal and validation of a new functional ambulation classification scale for clinical use", Arch Phys Med Rehabil, 86, pp.1234~1238 (2005)
- Viosca E, "Walking recovery after an acute stroke:assessment with a new functional classification and the Barthel Index", Arch Phys Med Rehabil, 86, pp.1239~1244 (2005)
- Van der Cruyssen K, "Prognostic factors for discharge destination after acute stroke: a comprehensive literature review", Disabil Rehabil, 37, pp.1214~1227 (2015)
- Santalucia P, "Sex differences in clinical presentation, severity and outcome of stroke: results from a hospital-based registry", Eur J Intern Med, 24, pp.167~171 (2013)
- Paolucci S, "Is sex a prognostic factor in stroke rehabilitation? A matched comparison", Stroke, 37, pp.2989~2994 (2006)