脑卒中后上肢运动功能与注意力的相关性：一项多中心横断面研究

摘要： 背景 上肢运动功能障碍是脑卒中后常见的功能障碍，注意力可能对上肢运动功能的恢复有影响，但目前上肢运动功能与注意力的相关性研究证据较少。 目的 探索脑卒中后上肢运动功能与注意力的相关性，为临床解决上肢功能康复问题提供新的思考角度。 方法 选取2023年3-10月在全国26家单位康复医学科住院的脑卒中患者480例为研究对象。采用Fugl-Meyer上肢运动功能评分（FMA-UL）和蒙特利尔认知评估量表（MoCA）分别评估患者上肢运动功能和注意力，采用Pearson相关性分析探究FMA-UL总分与MoCA中注意力评估项目得分的相关性。 结果 480例患者中有105例没有完成完整的评估，最终纳入脑卒中患者375例；平均FMA-UL总分（31.26±22.49）分；平均MoCA-注意力部分总分（4.74±1.60）分；平均注意-数字顺背/倒背任务得分（1.62±0.63）分；平均注意-读到1敲一下桌面任务得分（0.74±0.45）分；注意-100连续减7任务得分（2.39±0.95）分。男性患者FMA-UL总分高于女性（P<0.05）。全部患者的FMA-UL总分与MoCA-注意力部分总分、注意-数字顺背/倒背任务得分、注意-读到1敲一下桌面任务得分、注意-100连续减7任务得分均呈正相关（r值分别为0.226、0.146、0.195、0.182，P<0.05）；男性患者的FMA-UL总分与MoCA-注意力部分总分、注意-数字顺背/倒背任务得分、注意-读到1敲一下桌面任务得分、注意-100连续减7任务得分均呈正相关（r值分别为0.236、0.128、0.213、0.197，P<0.05）。 结论 脑卒中后上肢运动功能与注意力具有相关性且呈正相关，其中持续性注意力与上肢运动功能的相关程度较高，注意力的广度与上肢运动功能的相关程度较低。按照性别分组后，男性患者的上肢运动功能与注意力相关性同上，而女性患者的上肢运动功能与注意力相关性不显著，性别可能对上肢运动功能和注意力的相关性存在影响。

关键词: 脑卒中, 上肢, 运动功能, 注意力, 相关性分析

Abstract:

Background

Upper limb motor dysfunction is a common functional disorder after stroke. Attention may have an impact on the recovery of upper limb motor function, but there is little evidence of correlation between upper limb motor function and attention.

Objective

To explore the correlation between upper limb motor function and attention after stroke, and to provide a new perspective for clinical rehabilitation of upper limb function.

Methods

A total of 480 stroke patients who were hospitalized in the Department of Rehabilitation Medicine of 26 units in China from March to October 2023 were selected as the study subjects. The Fugl-Meyer Assessment Upper Limb (FMA-UL) and Montreal Cognitive Assessment (MoCA) were used to evaluate the upper limb motor function and attention of the patients, respectively. Pearson correlation analysis was used to explore the correlation between the total score of FMA-UL and the scores of attention assessment items in MoCA.

Results

Among the 480 patients, 105 patients did not finish the complete evaluation, so finally, 375 patients with stroke were included. The average FMA-UL score was (31.26±22.49) points. The average MoCA-Attention score was (4.74±1.60) points. The average Attention-Forward Digit Span and Backward Digit Span task score was (1.62±0.63) points; the average Attention-Vigilance task score was (0.74±0.45) points; the average Attention-Serial 7s task score was (2.39±0.95) points. The total FMA-UL score of male patients was higher than that of female patients (P<0.05). The total score of FMA-UL in all patients was positively correlated with the total score of MoCA-Attention, the score of Forward Digit Span and Backward Digit Span task, the score of Vigilance task, and the score of Serial 7s task (r=0.226, 0.146, 0.195, 0.182, P<0.05). The total score of FMA-UL in male patients was positively correlated with the total score of MoCA-Attention, the score of Forward Digit Span and Backward Digit Span task, the score of Vigilance task, and the score of Serial 7s task (r=0.236, 0.128, 0.213, 0.197, P<0.05) .

Conclusion

There is a significant and positive correlation between upper limb motor function and attention after stroke. The correlation between sustained attention and upper limb motor function is higher, and the correlation between attention span and upper limb motor function is lower. After grouping according to gender, the correlation between upper limb motor function and attention in male patients is the same as the above, while the correlation between upper limb motor function and attention in female patients is not significant, and gender may have an impact on the correlation between upper limb motor function and attention.

Key words: Stroke, Upper limb, Motor function, Attention, Correlation analysis

中图分类号: R 743

引用本文：

林嘉莉,张舒阳,林嘉滢,等. 脑卒中后上肢运动功能与注意力的相关性：一项多中心横断面研究[J]. 中国全科医学, 2025, 28(02): 208-213. DOI: 10.12114/j.issn.1007-9572.2024.0180.

LIN Jiali,ZHANG Shuyang,LIN Jiaying, et al. Correlation between Upper Limb Motor Function and Attention after Stroke: a Multicenter Cross-sectional Study[J]. Chinese General Practice, 2025, 28(02): 208-213. DOI: 10.12114/j.issn.1007-9572.2024.0180.

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