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Journal of the Korean Academy of Rehabilitation Medicine 2007;31(6):661-667.
Importance of Lesion Laterality in Hand Function Rehabilitation in Stroke Patients.
Kim, Kyoung Eun , Han, Tai Ryoon , Kim, Jung Hwan
1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea. tairyoon@snu.ac.kr
2Gangwon-do Rehabilitation Hospital, Korea.
3Kangwon National University College of Medicine, Korea.
뇌졸중 환자의 손 기능 재활에서 우성 및 비우성 반구 병변 여부의 중요성
김경은, 한태륜, 김정환1,2
서울대학교 의과대학 재활의학교실, 1강원도재활병원, 2강원대학교 의과대학
To investigate the relationship between the independence levels of ADL and the function of affected and unaffected hands using Modified Barthel Index (MBI) and Jebsen Hand Function Test (JHFT) at subacute and chronic stages of stroke.
Retrospective review was performed including unilateral stroke patients who had been admitted and evaluated with MBI and JHFT before discharge and 6 months after stroke onset. Correlations between sub-MBI related to hand function and JHFT were analyzed.
Thirty-one patients with dominant hemispheric lesion and 13 patients with non-dominant hemispheric lesion were included in this analysis. The evaluation was performed at 43.2±28.0 days post-stroke before discharge and followed at 200.0±46.1 days post-stroke. MBI scores and the JHFT scores of affected hand were significantly increased in both groups. At the time of discharge, both groups showed significant correlations between MBI scores and the JHFT scores of unaffected hand, but at 6 months post-stroke, significant correlations were found between MBI scores and the JHFT scores of dominant hand. Improvement of the 'stacking checker' item was significantly correlated with improvement of MBI in both groups.
In subacute stage, MBI reflects the function of unaffected hand, but in chronic stage, it rather reflects the function of dominant hand. The results suggest that rehabilitation concerning hand function may need different approach according to the lesion laterality. (J Korean Acad Rehab Med 2007; 31: 661-667)
Key Words: Cerebrovascular disorders, Rehabilitation, Activities of daily living, Functional laterality


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