中風後年齡、性別、及病理於捏力之影響：受影響較小對比受影響較大的手

Age, Sex, and Pathological Effects on Pinch Strengths After Stroke: The Less- Versus More-affected Hands

年齡、性別和中風病理如何影響捏力仍是不確定的。本研究的目的是比較中風患者之受影響較小和受影響較大的手的捏力、調查年齡和性別對其受影響較小和受影響較大的手捏力的影響、及檢驗其受影響較小和受影響較大的手捏力的預測指標。從兩家醫院招募80位被診斷為單側中風的受試者（年齡在40至80歲之間）。並收集人口學特徵和通過上肢傅格梅爾評估量表(Fugl-Meyer Assessment of the Upper Extremity,FMA-UE)評估其臨床特徵。個案的指側捏力和指尖捏力使用Jamar®Plus+電子捏力器進行測量。統計使用二因子變異數分析、廣義估計方程式及多元線性迴歸分析。結果顯示男性中風患者之受影響較小的手的捏力（無論是否為慣用手）和受影響較大的手為慣用手的捏力皆顯著高於女性；年齡則影響中風患者的受影響較小的手且為慣用手的指側捏力、及受影響較小的手且為非慣用手的指尖捏力；除了年齡和性別的影響外，亦發現FMA-UE為受影響較大的手捏力的重要預測指標。年齡和性別會影響中風患者受影響較小的手的捏力，而年齡、性別和上肢動作功能則會影響其受影響較大的手的捏力；建議治療師在評估和治療時必須考慮這些因素。

How age, sex, and pathological effects of stroke affect pinch strengths is still uncertain. This study was to compare the pinch strengths, to investigate the influence of age and sex on pinch strengths, and to examine the predictors of pinch strengths in the less- and more-affected hands in patients with stroke. Eighty participants (aged from 40 to 80) diagnosed with unilateral stroke were recruited from two urban hospitals. The demographic and clinical characteristics, as assessed with the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), were collected. Lateral and tip pinch strengths were measured with the Jamar®Plus+ Digital Pinch Gauge. Two-way ANOVA and multiple linear regression analyses, and the generalized estimating equation were used. For sex difference of stroke participants, pinch strengths of the less-affected hand without regard to hand dominance and those of the more-affected dominant hand were significantly higher in males than in females. The age effect was noted in lateral pinch strength of the less-affected hand in stroke patients with the dominant hand affected, and tip pinch strength of the less-affected hand in stroke patients with the non-dominant hand affected. In addition to age and sex, the FMA-UE was found to be the significant predictor in the pinch strengths of the more-affected hand. Age and sex affect pinch strengths in the less-affected hands of patients, and age, sex and upper-limb motor function affect them in the more-affected hands; that therapists must consider these factors while evaluating and treating.