Background. Sleep is important for consolidation of motor learning, but brain injury may affect sleep continuity and therefore rehabilitation outcomes. Objective. This study aims to assess the relationship between sleep quality and motor recovery in brain injury patients receiving inpatient rehabilitation. Methods. Fifty-nine patients with brain injury were recruited from 2 specialist inpatient rehabilitation units. Sleep quality was assessed (up to 3 times) objectively using actigraphy (7 nights) and subjectively using the Sleep Condition Indicator. Motor outcome assessments included Action Research Arm test (upper limb function), Fugl-Meyer Assessment (motor impairment), and the Rivermead Mobility Index. The Functional Independence Measure (FIM) was assessed at admission and discharge by the clinical team. Fifty-five age- and gender-matched healthy controls completed one assessment. Results. Inpatients demonstrated lower self-reported sleep quality (P < .001) and more fragmented sleep (P < .001) than controls. For inpatients, sleep fragmentation explained significant additional variance in motor outcomes, over and above that explained by admission FIM score (P < .017), such that more disrupted sleep was associated with poorer motor outcomes. Using stepwise linear regression, sleep fragmentation was the only variable found to explain variance in rate of change in FIM (R2adj = 0.12, P = .027), whereby more disrupted sleep was associated with slower recovery. Conclusions. Inpatients with brain injury demonstrate impaired sleep quality, and this is associated with poorer motor outcomes and slower functional recovery. Further investigation is needed to determine how sleep quality can be improved and whether this affects outcome.

中文翻译：

---

脑损伤后睡眠中断与更差的运动结果和较慢的功能恢复有关

背景。睡眠对于巩固运动学习很重要，但脑损伤可能会影响睡眠连续性，从而影响康复结果。目标。本研究旨在评估接受住院康复治疗的脑损伤患者的睡眠质量与运动恢复之间的关系。方法。从 2 个专科住院康复科招募了 59 名脑损伤患者。使用活动记录仪（7 晚）客观评估睡眠质量（最多 3 次），并使用睡眠状况指标主观评估。运动结果评估包括 Action Research Arm 测试（上肢功能）、Fugl-Meyer 评估（运动障碍）和 Rivermead 活动指数。临床团队在入院和出院时评估了功能独立性测量 (FIM)。55 名年龄和性别匹配的健康对照完成了一项评估。结果。与对照组相比，住院患者表现出较低的自我报告睡眠质量 (P < .001) 和更碎片化的睡眠 (P < .001)。对于住院患者，睡眠碎片化解释了运动结果的显着额外差异，超出了入院 FIM 评分所解释的范围 (P < .017)，因此睡眠中断越多，运动结果越差。使用逐步线性回归，睡眠碎片是发现的唯一可以解释 FIM 变化率变化的变量（R2adj = 0.12，P = .027），其中睡眠中断越多，恢复越慢。结论。脑损伤住院患者表现出睡眠质量受损，这与较差的运动结果和较慢的功能恢复有关。