Upper Extremity In Patients Research Articles

Microcirculatory Dysfunction in Patients With Diabetes Mellitus Detected by a Distributed System of Wearable Laser Doppler Flowmetry Analysers.

The paper is devoted to the study of perfusion and amplitude-frequency spectra of laser Doppler flowmetry (LDF) signals in patients with diabetes mellitus (DM) in different skin areas of the upper and lower extremities using a distributed system of wearable LDF analysers. LDF measurements were performed in the areas of the fingers, toes, wrists and shins. The mean perfusion values, the amplitudes of blood flow oscillations in endothelial, neurogenic, myogenic, respiratory and cardiac frequency ranges, and the values of nutritive blood flow were analysed. The results revealed a decrease in tissue perfusion and nutritive blood flow in the lower extremities and an increase in these parameters in the upper extremities in patients with DM. A decrease in the amplitudes of endothelial and neurogenic oscillations was observed. The obtained results confirm the possibility of using wearable LDF analysers to detect differences in the blood flow regulation in normal and pathological conditions.

Assessment of the long-term trend in angiodystonic syndrome of the upper extremities in stage I vibration disease using the ultrasound method

Introduction. Diseases of the upper extremities caused by exposure to local vibration at the workplace are a ubiquitous problem. These diseases occur or are aggravated by exposure to vibration at the workplace when using vibration-hazardous equipment. Purpose of the study – is to identify the features of upper limb angiodystonic syndrome in vibration disease at stage I, depending on work experience. Materials and methods. Ultrasound scanning of the arteries of the upper extremities was performed in seventy patients. Spectral and velocity indices such as resistance index (RI), diastolic blood flow rate (V ED), systolic (pulse) blood flow rate (V PS) and pulsation index (PI) were measured in the distal part of the forearm. Results. Upon contact with a vibration tool, for each year of work experience, the systolic (pulse) blood flow rate (V PS) in the radial and left ulnar arteries significantly were found to decrease by an average of 0.57–0.58 (p<0.05). In the ulnar artery, PI increases on average by 0.03–0.062, but the changes are not statistically significant (p>0.05). With an increase in the length of service by 1 year, the RI in the left radial and ulnar arteries significantly increases by 0.0003–0.0012 (p<0.05). Limitations of the study. The main disadvantages of ultrasound are the long-term and operator-dependent method. Conclusion. With an increase in work experience, the indices characterizing angiodistonic disorders: pulsation index (PI), resistance index (RI) – significantly increase with each year of experience when exposed to local vibration. This can be used for differential diagnosis of peripheral angiodistonic upper limb syndrome of occupational etiology, in particular, vibration disease associated with exposure to local vibration at stage 1. With an increase in work experience, the indices characterizing angiodistonic disorders: pulsation index (PI), resistance index (RI) – significantly elevate with each year of experience when exposed to local vibration. As part of the ultrasound screening study, scanning of the arteries of the upper extremities in patients at the clinic of occupational pathology can be performed at the preclinical stage to prevent prolonged chronic ischemia of the upper extremities. This diagnostic method can be especially valuable in differentiating peripheral angiodistonic upper limb syndrome of occupational etiology, in particular, vibration disease at the stage 1.

Clinical, Radiographic, and Biomechanical Evaluation of the Upper Extremity in Patients with Osteogenesis Imperfecta.

Introduction: Osteogenesis imperfecta (OI) is a hereditary disorder primarily caused by mutations in type I collagen genes, resulting in bone fragility, deformities, and functional limitations. Studies on upper extremity deformities and associated functional impairments in OI are limited. This cross-sectional study aimed to evaluate upper extremity deformities and functional outcomes in OI. Methods: We included patients regardless of their OI subtypes with a minimum age of 7 years. Radiographic analysis of radial head dislocation, ossification of the interosseous membrane, and/or radioulnar synostosis of the forearm were performed, and deformity was categorized as mild, moderate, or severe. Clinical evaluation was performed using the Quick Disabilities of Arm, Shoulder, and Hand (qDASH) questionnaire and shoulder-elbow-wrist range of motion (ROM). Three-dimensional motion analysis of the upper limb was conducted using the Southampton Hand Assessment Procedure (SHAP). The SHAP quantifies execution time through the Linear Index of Function (LIF) and assesses the underlying joint kinematics using the Arm Profile Score (APS). Additionally, the maximum active Range of Motion (aRoM) was measured. Results: Fourteen patients aged 8 to 73 were included. Radiographic findings revealed diverse deformities, including radial head dislocation, interosseous membrane ossification, and radioulnar synostosis. Six patients had mild, six moderate, and two severe deformities of the upper extremity. Severe deformities and radial head dislocation correlated with compromised ROM and worse qDASH scores. The qDASH score ranged from 0 to 37.5 (mean 11.7). APS was increased, and LIF was reduced in OI-affected persons compared with non-affected peers. APS and LIF also varied depending on the severity of bony deformities. aRoM was remarkably reduced for pro-supination. Conclusion: Patients with OI showed variable functional impairment from almost none to severe during daily life activities, mainly depending on the magnitude of deformity in the upper extremity. Larger multicenter studies are needed to confirm the results of this heterogeneous cohort. Level of evidence: Retrospective clinical study; Level IV.

Contemporary Management of the Upper Limb in Apert Syndrome: A Review.

Apert syndrome is a relatively rare genetic disorder with a constellation of distinct craniofacial deformities and bilateral syndactyly of the hands and feet. Although the literature contains ample evidence for the need to treat cranial, midfacial, and hand abnormalities, there are severe shortcomings in the literature when attempting to describe the pathology and management of the entire upper limb in patients with Apert syndrome. A thorough literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar, on the management of the upper extremity in Apert syndrome, including the shoulder, elbow, and hand. Our findings of the literature discuss the clinical presentation and management trends of the upper extremity in patients with Apert syndrome. Through multicenter collaboration, discussion among experts in the field, and evidence gathered from the literature, we propose treatment algorithms to treat deformities of the hand, shoulder, and elbow in patients with Apert syndrome. This review identifies that even if hand pathologies have been correctly treated, shoulder and elbow abnormalities in patients with Apert syndrome are largely ignored. To optimize outcomes, added cognizance of additional upper limb congenital differences and their management should be highly advocated in this patient population.

A new active rehabilitation training mode for upper limbs based on Tai Chi Pushing Hands

Robot-assisted rehabilitation is a crucial approach to restoring motor function in the limb. However, the current training trajectory lacks sufficient theoretical or practical support, and the monotony of single-mode training is a concern. Tai Chi Pushing Hands, a beneficial and effective daily exercise, has been shown to improve balance function, psychological state, and motor function of the upper extremities in patients recovering from stroke. To address these issues, we propose a new active rehabilitation training that incorporates Tai Chi Pushing Hands movements and yin-yang balance principles. The training trajectory and direction are encoded by the velocity field and consist of two processes: yang (push) and yin (return). During yang, the limb actively pushes the robot to move, while during yin, the limb actively follows the robot’s movement. To provide necessary assistance, an admittance controller with self-adaptive parameters is designed. In addition, we introduce two indexes, the ‘Intention Angle’ (ϖ) and the time ratio (Γ), to evaluate motion perception performance. Our experiment was conducted on a 4-degree-of-freedom upper limb rehabilitation robot platform, and the subjects were separated into a familiar group and an unfamiliar group. The experiment results show that the training could be completed well no matter whether the subject is familiar with Tai Chi Pushing Hands or not. The parameters and the movement of the robot can be adjusted based on the interactive force to adapt to the ability of the subject.

Reconstruction of Upper Extremity Peripheral Nerve Injuries Using an Epineurial-Like Collagen Device—A Prospective Clinical Study

Abstract Background Epineurium acts as a barrier to protect nerves from injury and maintains its structural and functional integrity. A device was developed to mimic the native structure of epineurium. The aim of this study was to evaluate its biological characteristics and clinical performance in the reconstruction of upper extremity peripheral nerves. Methods Scanning electron microscopy, transmission electron microscopy, and enhanced microcomputed tomography were used to examine the ultrastructural characteristics of the device. A prospective case series with 2-year follow-up was undertaken and reported. Patients who required nerve reconstruction in the upper extremities were included and underwent single or multiple nerve reconstructions in one or both upper limbs. Results The device mimics the structural and biological properties of epineurium. During surgical use, it can form compression-free and self-engaged wrapping around the repaired nerves. A total of 36 peripheral nerve reconstructions were performed using either nerve transfer or nerve grafting in 19 patients. Of these, 14 patients had upper limb nerve injuries and 5 had C5 to C8 spinal cord injuries resulting in tetraplegia. Nerve reconstruction using the device restored peripheral nerve function, with functional motor recovery (FMR) observed in 76% of the most proximal target muscle at 12 months and 85% of most proximal muscles at 24 months post-treatment. FMR was observed in 61% of all target muscles at 12 months and 75% at 24 months post-treatment. Conclusion The device restored FMR in the upper extremities in patients with peripheral nerve or spinal cord injuries. Level of Evidence Therapeutic IV

Comparative Efficacy of Constrained Induced Movement Therapy and Motor-Relearning Program in Post Stroke Upper Extremity Function

Background: Stroke often leads to significant impairments in motor function, particularly in the upper extremities. Constraint-Induced Movement Therapy (CIMT) and Motor Relearning Program (MRP) are two rehabilitation approaches that have shown potential in addressing these deficits. This study aimed to compare the effectiveness of these two therapies in improving upper extremity function in post-stroke hemiplegia. Objective: To evaluate and compare the efficacy of CIMT and MRP in enhancing motor recovery and functional performance of the upper extremity in patients with post-stroke hemiplegia. Methods: This randomized controlled trial included patients aged 35-60 years diagnosed with ischemic or hemorrhagic stroke, confirmed by CT scans and MRI. Patients were randomly assigned to either the CIMT group or the MRP group, each comprising 16 participants. Both groups underwent respective therapies for two hours daily, six days a week, for four weeks. The Motor Assessment Scale and the Functional Independence Measure (FIM) Scale were employed for pre-, post-, and follow-up evaluations. Results: Both groups showed significant improvements in motor function and daily living activities. The CIMT group exhibited greater advancements, with notable increases in upper extremity strength and active range of motion in the shoulder, elbow, and wrist joints. Quantitative improvements in the CIMT group included an average increase of 2 points in Motor Assessment Scale scores and a 15% improvement in FIM scores. The MRP group demonstrated an average increase of 1.5 points in Motor Assessment Scale scores and a 10% improvement in FIM scores. Conclusion: While both CIMT and MRP are effective in improving motor function and daily living activities in patients with post-stroke hemiplegia, CIMT showed a slight edge in enhancing upper extremity strength and range of motion. These findings suggest that CIMT could be a more efficacious approach in the rehabilitation of upper extremity function in stroke patients.

Polymorphism of cytokine and C-reactive protein genes in patients with psoriasis in the Kemerovo region of Russia

Aim. To study the associations of polymorphisms of IL-1b (rs16944), IL-6 (rs1554606), IL-8 (rs2227306), IL-10 (rs1800896), TNFα (rs361525), CRP (rs1205) genes and their intergenic interactions with the risk of psoriasis development in Kemerovo region residents. Materials and Methods. We examined 170 patients (102 men and 78 women) a clinically established diagnosis of vulgar psoriasis. The average age of patients was 46.2+3.9 years, 165 people (97%) had progressive stage psoriasis. The control group (n=155) included 98 healthy men and 57 women matched by age. Genomic DNA isolated from peripheral blood leukocytes by phenol-chloroform extraction according to the standard protocol was used as material. Logistic regression analysis was performed to assess the role of intergenic interactions in the development of psoriasis. Conclusion. In patients of the Kemerovo region, vulgar psoriasis is associated with minor homozygous genotypes of polymorphic variants of TNFα (rs361525), IL-1b (rs16944), CRP (rs1205) genes. The minor homozygous TNFα (rs361525) genotype has a high odds ratio and is determinant in the development of this form of psoriasis among all genes studied. The major allele and IL-10 genotype (rs1800896) is a disease modifier and affects the clinical course, particularly the development of inflammatory plaques and papules on the lower and upper extremities of patients.

Infectious complications of external fixation in patients with polytrauma

Annotation. Among the main causes of mortality and in the structure of primary disability in Ukraine, the consequences of injuries consistently rank third, second only to cardiovascular and oncological diseases. The intensive use of implants in traumatology and orthopedics in the second half of the 20th century, along with significant advantages in the tactics of surgical treatment and further improvement of the quality of life of patients, also contributed to the emergence of infection. The purpose of our work was to determine the features of the occurrence and localization of the infectious process after external fixation as a result of polytrauma. An analysis of the treatment of 181 patients who were hospitalized in the Department of osteomyelitis surgery at the Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine was conducted. Statistical processing was carried out using the method of calculating the coefficient of the polychoric relationship indicator according to K. Pearson. As our study indicated, in 93.6% of patients with infectious complications of external fixation as a result of polytrauma, the pathological process was localized in the lower limb, which is associated with high-energy injuries inherent in multisystemic and multiorgan damage. Most often, the purulent process in patients with external fixation as a result of polytrauma was found in the lower third of the tibia (21.0%), the middle third of the tibia (17.9%) and the lower third of the femur (15.8%). Purulent complications in the area of the upper extremity in patients with external fixation as a result of polytrauma were observed four times less often than in patients with the same complications as a result of an isolated injury.

Biomechanical evaluation of the upper extremity in patients with osteogenesis imperfecta - a pilot study

Biomechanical evaluation of the upper extremity in patients with osteogenesis imperfecta - a pilot study

A successful process of treatment with necrotizing fasciitis of upper extremities in patients with diabetes mellitus: a case report.

This case report presents on a patient with diabetes mellitus rapidly developed a NF of the upper extremities following a minor trauma in the palmar of greater thenar. In the initial stages of her hospital admission, severe hand soft tissue infection, and systemic toxicity is the most prominent clinical manifestation. During her hospitalization, efficacious multidisciplinary treatment was carried out to avoid severe consequences. The objective of this case report is to present a successful individual strategy in a complex case to standardize the treatment process. Accurate and standardized management can improve the prognosis of patients affected from upper extremities NF of diabetic avoiding and severe complications and saving lives.

Surgical treatment of lymphedema of the upper extremities in patients with post-mastectomy syndrome

Surgical treatment of lymphedema of the upper extremities in patients with post-mastectomy syndrome

ОЦЕНКА МЕЛКОЙ МОТОРИКИ РУК У БОЛЬНЫХ ПОСЛЕ ДЕКОМПРЕССИИ ВЕНТРАЛЬНОГО СУБАКСИАЛЬНОГО ЦЕРВИКОСПОНДИЛОДЕЗА

Abstract. Aim. Improving the long-term results of surgical treatment requires not only timely diagnosis, but also self- monitoring of the dynamics of impaired functions on the part of the patient. The aim of the study was to establish the reliability of the test by comparing its results with clinical data and information from electroneuromyography of the upper extremities in patients after decompression-ventral subaxial fusion. Material and methods. The presence of motor disorders reduction or loss of bicipital, tricipital and carporadial reflexes and electroneuromyography data was compared with the results of the method according to patent RU2717365C1 in 27 patients after decompression- ventral subaxial cervicospondylodesis due to diseases and injuries of the cervical spine. Results and discussion. It was found that the test was slowed down in patients with motor deficiency of the upper extremities with a corresponding level of damage to the performed reverse gesture. The same pattern with respect to the decrease or absence of appropriate reflexes, as well as the slowing down of the motor spine system according to the electroneuromyography. Conclusions. The test is quite sensitive and objective, can be recommended to patients for self-control. The use of this method for patients does not cancel the need for planned diagnostic measures and does not replace them. The development of such tests can help improve the selection of rehabilitation measures.

Clinical Presentation and Characteristics of the Upper Extremity in Patients with Musculocontractural Ehlers-Danlos Syndrome.

Musculocontractural Ehlers-Danlos syndrome (mcEDS) is a subtype of EDS caused by defective dermatan sulfate biosynthesis, characterized by multiple malformations (craniofacial features, ocular and visceral malformations) and progressive cutaneous, skeletal, vascular, and visceral fragility-related manifestations. Repeated dislocations and deformities of the joints due to joint relaxation are observed, causing serious damage to the musculoskeletal system of the whole body; however, the motor function of the upper limbs and the morphology of the bone joints have not been systematically investigated. In this study, we present a detailed and comprehensive report on upper limb lesions of 13 patients with a mean age at the first visit of 21 years. Twelve patients (92.3%) had a history of dislocation. Eleven patients (84.6%) had shoulder dislocations, and two patients (15.4%) had elbow dislocations. Four patients (30.8%) had elbow osteoarthritis, and three patients (23.1%) had distal radioulnar joint (DRUJ) osteoarthritis. The phalanges and metacarpals are thin, and the ratio of medullary cavity of the metacarpal bone decreases with age. As bone and joint deformity progresses, patients with mcEDS should be recommended to receive regular follow-up, including radiology. The present findings suggest an important role for dermatan sulfate in the maintenance of the skeletal system.

Analysis of Muscular Electrical Activity and Blood Perfusion of Upper Extremity in Patients with Hemiplegic Shoulder Pain: A Pilot Study.

Background Hemiplegic shoulder pain (HSP) is a common symptom for post-stroke patients, which has a severely adverse impact on their rehabilitation outcomes. However, the cause of HSP has not been clearly identified due to its complicated multifactorial etiologies. As possible causes of HSP, the abnormality of both muscular electrical activity and blood perfusion remains lack of investigations. Objective This study aimed to analyze the alteration of muscular electrical activity and blood perfusion of upper extremity in patients with HSP by using surface electromyography (sEMG) and laser speckle contrast imaging (LSCI) measurement techniques, which may provide some insight into the etiology of HSP. Methods In this observational and cross-sectional study, three groups of participants were recruited. They were hemiplegic patients with shoulder pain (HSP group), hemiplegic patients without shoulder pain (HNSP group), and healthy participants (Healthy group). The sEMG data and blood perfusion data were collected from all the subjects and used to compute three different physiological measures, the root-mean-square (RMS) and median-frequency (MDF) parameters of sEMG recordings, and the perfusion unit (PU) parameter of blood perfusion imaging. Results The RMS parameter of sEMG showed significant difference (p < 0.05) in the affected side between HSP, HNSP, and Healthy groups. The MDF parameter of sEMG and PU parameter of blood perfusion showed no significant difference in both sides among the three groups (p > 0.05). The RMS parameter of sEMG showed a statistically significant correlation with the pain intensity (r = -0.691, p =0.012). Conclusion This study indicated that the muscular electrical activity of upper extremity had a correlation with the presence of HSP, and the blood perfusion seemed to be no such correlation. The findings of the study suggested an alternative way to explore the mechanism and treatment of HSP.

Effects of myofascial release with tennis ball on spasticity and motor functions of upper limb in patients with chronic stroke: A randomized controlled trial.

Background:Impaired motor function and upper extremity spasticity are common concerns in patients after stroke. It is essential to plan therapeutic techniques to recover from the stroke. The objective of this study was to investigate the effects of myofascial release with the tennis ball on spasticity and motor functions of the upper extremity in patients with chronic stroke.Methods:Twenty-two chronic stroke patients (male-16, female-6) were selected to conduct this study. Two groups were formed: the control group (n=11) which included conventional physiotherapy only and the experimental group (n=11) which included conventional physiotherapy along with tennis ball myofascial release – in both groups interventions were performed for 6 sessions (35 minutes/session) per week for a total of 4 weeks. The conventional physiotherapy program consisted of active and passive ROM exercises, positional stretch exercises, resistance strength training, postural control exercises, and exercises to improve lower limb functions. All patients were evaluated with a modified Ashworth scale for spasticity of upper limb muscles (biceps brachii, pronator teres, and the long finger flexors) and a Fugl-Meyer assessment scale for upper limb motor functions before and after 4 weeks. Nonparametric (Mann–Whitney U test and Wilcoxon signed-rank test) tests were used to analyze data statistically. This study has been registered on clinicaltrial.gov (ID: NCT05242679).Results:A significant improvement (P < .05) was observed in the spasticity of all 3 muscles in both groups. For upper limb motor functions, significant improvement (P < .05) was observed in the experimental group only. When both groups were compared, greater improvement (P < .05) was observed in the experimental group in comparison to the control group for both spasticity of muscles and upper limb motor functions.Conclusion:Myofascial release performed with a tennis ball in conjunction with conventional physiotherapy has more beneficial effects on spasticity and motor functions of the upper extremity in patients with chronic stroke compared to conventional therapy alone.

Correlative study between attention deficits and upper extremity motor dysfunction after stroke

Background/aim: Motor dysfunction is one of the major byproducts of stroke; however, another domain that is severely affected yet mostly neglected is cognition. It is not certain yet whether a relationship between cognitive impairment (attention) and upper-limb motor impairment is present. The aim of our study was to investigate the correlation between attention deficits with upper limb motor dysfunction after stroke. Material and methods: Sixty stroke survivors were recruited in this correlational study. Upper limb motor function was evaluated by the Upper Limb Functional Index (ULFI). Attention deficits were evaluated by the Mini Mental State Examination (MMSE). For correlation, data were imported into Statistical Package for the Social Sciences (SPSS version 20.0). A result was considered statistically significant when p was &lt;0.05. Chi-Square testΧ² was used to test the association variables for categorical data. Results: There was significant correlation between Mini Mental State Examination with motor functions MMSE with ULFI (r=.295*, p=.022). Conclusion: There is a significant correlation between attention deficits and motor dysfunction of the upper extremities in patients after stroke.&#x0D;

Proprioceptive Training with Visual Feedback Improves Upper Limb Function in Stroke Patients: A Pilot Study.

Proprioceptive deficit is one of the common sensory impairments following stroke and has a negative impact on motor performance. However, evidence-based training procedures and cost-efficient training setups for patients with poststroke are still limited. We compared the effects of proprioceptive training versus nonspecific sensory stimulation on upper limb proprioception and motor function rehabilitation. In this multicenter, single-blind, randomized controlled trial, 40 participants with poststroke hemiparesis were enrolled from 3 hospitals in China. Participants were assigned randomly to receive proprioceptive training involving passive and active movements with visual feedback (proprioceptive training group [PG]; n = 20) or nonspecific sensory stimulation (control group [CG]; n = 20) 20 times in four weeks. Each session lasted 30 minutes. A clinical assessor blinded to group assignment evaluated patients before and after the intervention. The primary outcome was the change in the motor subscale of the Fugl-Meyer assessment for upper extremity (FMA-UE-M). Secondary outcomes were changes in box and block test (BBT), thumb localization test (TLT), the sensory subscale of the Fugl-Meyer assessment for upper extremity (FMA-UE-S), and Barthel Index (BI). The results showed that the mean change scores of FMA-UE were significantly greater in the PG than in the CG (p = 0.010 for FMA-UE-M, p = 0.033 for FMA-UE-S). The PG group was improved significantly in TLT (p = 0.010) and BBT (p = 0.027), while there was no significant improvement in TLT (p = 0.083) and BBT (p = 0.107) for the CG group. The results showed that proprioceptive training was effective in improving proprioception and motor function of the upper extremity in patients with poststroke. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2000037808).

Venous obstruction of the upper extremities in patients with pacemakers: D-dimer testing

<h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Оценка распространенности, факторов риска нарушения проходимости вен верхних конечностей и их взаимосвязи с уровнем D-димера у пациентов с электрокардиостимуляторами (ЭКС). <h3>МАТЕРИАЛ И МЕТОДЫ</h3> В исследование включен 51 пациент, который был госпитализирован для плановой замены ЭКС. Перед операцией всем пациентам были проведены ультразвуковое дуплексное сканирование вен верхних и нижних конечностей, эхокардиография, забор периферической венозной крови для определения уровня D-димера. <h3>РЕЗУЛЬТАТЫ</h3> Нарушение проходимости вен верхних конечностей выявлено у 7 (13,7%) пациентов. У этой категории пациентов уровень D-димера был выше, чем у остальных 44 обследованных — 1000 [1000; 4000] мг/л DDU против 500 [300; 800] мг/л DDU (<i>p</i>=0,002). По данным ROC-анализа уровень D-димера был ассоциирован с нарушением проходимости вен верхних конечностей у пациентов с имплантированными ЭКС (AUC 0,851±0,073, 95% ДИ 0,708—0,993; <i>p</i>=0,003). Порог классификации по индексу Юдена — 900 мг/л DDU. Чувствительность такой модели составляет 85,7%, специфичность — 77,3%. С нарушением проходимости вен верхних конечностей у пациентов с ЭКС были ассоциированы прием антиагрегантов (ацетилсалициловой кислоты) по сравнению с применением антикоагулянтов (ОШ 11,6, 95% ДИ 1,28—105,41; <i>p</i>=0,029) и вторая по счету замена ЭКС (ОШ 5,85, 95% ДИ 1,004—34,1; <i>p</i>=0,049). <h3>ЗАКЛЮЧЕНИЕ</h3> Определение уровня D-димера у пациентов с ЭКС может служить методом скрининга нарушения венозной проходимости и в ряде случаев позволяет избежать проведения инструментальных методов обследования. Факторами, ассоциированными с нарушением проходимости вен верхних конечностей, являются прием ацетилсалициловой кислоты в качестве антиагрегантного препарата по сравнению с антикоагулянтной терапией и вторая замена ЭКС, отражающая более продолжительные сроки электрокардиостимуляции у пациента.

Correlation of Body Composition via Bioelectrical Impedance Analysis and Motor Function and Recovery of Upper Extremity in Patients Undergoing Stroke Rehabilitation.

Bioelectrical impedance analysis (BIA) has been used to investigate the body compositions and predict functional outcomes in patients with stroke, while the role of BIA to predict motor function or recovery in stroke has not been clarified. This study aimed to investigate relationship between body composition measured by BIA and upper limb motor function and recovery. Body compositions (soft tissue lean mass, phase angle, body fat mass and body water) of fifty patients who are admitted to the stroke rehabilitation unit were segmentally analyzed via BIA. The motor recovery of upper extremity (UE) was evaluated via Fugl-Meyer Assessment (UE-FMA) at the time of transfer and discharge. Correlations between body composition and UE-FMA at discharge were analyzed using Spearman correlation coefficient. Multiple regression analysis was used to determine the regression between body composition and motor function and recovery. The Δ Phase angle, the difference of both sides was significantly linearly inversely correlated with UE-FMA at discharge. However, in multiple regression analysis, body compositions including phase angle did not significantly predict motor function at discharge or motor recovery. The Δ Phase angle is related to the severity of upper limb motor function at discharge in subacute stroke patients, and further studies are needed to determine its value as a predictor for motor recovery.