Author/Editor		Goljar, Nika; Kotnik, Slavi
Title		Ocenjevanje funkcije roke pri bolnikih po možganski kapi s Southamptonskim testom (SHAP)
Translated title		Hand function evaluation with the Southampton Hand Assessment Procedure (SHAP) in stroke patients
Type		članek
Vol. and No.		Letnik 14, št. 1
Publication year		2015
Volume		str. 4-10
ISSN		1580-9315 - Rehabilitacija
Language		slv
Abstract		Izhodišča: Izboljšanje funkcije zgornjega uda po možganski kapi naj bi bilo v večini primerov odvisno od izboljšanja funkcije roke. Za dobro funkcijo roke je potreben natančen nadzor in koordinacija gibanja in sil, ki jih tvorijo prsti. Sposobnosti prijemanja lahko ocenjujemo s testom SHAP (Southampton Hand Assessment Procedure). Namen prispevka je bil prikazati uporabnost testa SHAP za oceno in spremljanje sprememb funkcije roke pri bolnikih po možganski kapi. Metode: V retrospektivno raziskavo smo vključili 60 bolnikov po možganski kapi, ki smo jih sprejeli v bolnišnično rehabilitacijsko obravnavo in pri katerih smo izvedli test SHAP pred pričetkom ter ob koncu terapevtskih programov. Rezultati: Skupni indeks funkcioniranja okvarjene in neokvarjene roke se je pri bolnikih z okvaro leve in desne možganske poloble statistično značilno razlikoval (I<0,01). Indeks funkcioniranja je bil ob odpustu statistično značilno višji tako za okvarjeno kot neokvarjeno roko v primerjavi z indeksom ob sprejemu (p<0,01). Največkrat so bili nižje ocenjeni triprstni prijem, cilindrični in pincetni prijem. Pred začetkom rehabilitacije je imelo 38 bolnikov skupno oceno indeksa funkcioniranja nižjo od meje za normalno funkcioniranje na obeh rokah, ob odpustu je bilo takih 20 bolnikov. Petuporaindvajset bolnikov je imelo blažje motnje zaznavanja, statistično značilno povezane s funkcijo okvarjene roke (r=0,25; p=0,05). Zaključki: S testom SHAP lahko pri bolnikih po možganski kapi z večjo funkcijsko zmogljivostjo primerno ocenimo in spremljamo funkcijo roke skozi čas. Prednost testa je, da lahko testiramo vsako roko posebej. Pomanjkljivost testa pa je, da bolniki naloge izvedejo le enkrat, tako da s testom ne moremo oceniti morebitnega slabšanja funkcije roke zaradi utrujanja.Background: Improvement of upper limb function in stroke patients is largely determined by changes in hand function. Optimal hand function requires precise control and coordination of movement and forces produced by fingers. The specific grip patterns can be evaluated by the Southampton Hand Assessment Procedure (SHAP). The aim of our study was to evaluate the use of SHAP for impairment assessment and monitoring change or improvement in stroke patients. Methods: A retrospective study was performed that involved sixty stroke patients admitted to inpatient rehabilitation and assessed by SHAP ad admission and discharge. Results: The indices of function of the impaired hand after brain lesion either in the left or in the right hemisphere were statistically significantly lower than those of the unimpaired hand (p<0.01), and were significantly higher on the impaired and the unimpaired side at discharge (p<0.01). The tripod, cylindrical and tip scores were the lowest. The indices of function of both hands of 38 patients at admission and 20 patients at discharge were below the threshold for no impairment. Twenty-five patients had mild somatosensory deficits, whereby the correlation of somatosensory deficits with impaired hand function was statistically significant (r=0.25, p=0.05). Conclusions: The SHAP is an appropriate test for assessing hand function impairments and monitoring changes or improvements over time in mildly disabled stroke patients. The advantage of the SHAP is the separate assessment of both hands; a disadvantage of the test is the one-time performance of the tasks, which does not expose possible fatigue after repeated performance.
Descriptors		Stroke
Keywords		hand function Southampton Hand Assessment Procedure SHAP možganska kap funkcija roke SHAP Southamptonski test za ocenjevanje roke