Taub E, Morris D M
Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd., CH415, Birmingham, AL 35294-1170, USA.
Curr Atheroscler Rep. 2001 Jul;3(4):279-86. doi: 10.1007/s11883-001-0020-0.
A therapeutic approach to rehabilitation of movement after stroke, termed constraint-induced (CI) movement therapy, has been derived from basic research with monkeys given somatosensory deafferentation. CI therapy consists of a family of therapies; their common element is that they induce persons with stroke to greatly increase the use of a more-affected upper extremity (UE) for many hours a day over a 2- to 3-week period. These therapies have significantly improved quality of movement and substantially increased amount of use of a more-affected UE in the activities of daily living in life situations. A number of neuroimaging and transcranial magnetic stimulation studies have shown that the massed practice of CI therapy produces a massive use-dependent cortical reorganization that increases the area of cortex involved in the innervation of movement of the more-affected UE. The intensity and schedule of delivery of this very efficacious therapy is quite different from that of more traditional physical rehabilitation approaches. As a result, to be clinically applicable, the CI therapy approach to rehabilitation will likely require a paradigm shift in the delivery of physical rehabilitation services.
一种针对中风后运动康复的治疗方法，称为强制性诱导（CI）运动疗法，它源自对接受体感去传入神经支配的猴子进行的基础研究。CI疗法由一系列疗法组成；它们的共同要素是，在2至3周的时间里，促使中风患者每天花费数小时大量增加对受影响更严重的上肢（UE）的使用。这些疗法显著改善了运动质量，并大幅增加了在日常生活活动中受影响更严重的UE的使用量。多项神经影像学和经颅磁刺激研究表明，CI疗法的集中练习会产生大量依赖使用的皮质重组，增加了参与受影响更严重的UE运动神经支配的皮质区域。这种非常有效的疗法的强度和实施计划与更传统的物理康复方法有很大不同。因此，为了在临床上适用，CI疗法的康复方法可能需要在物理康复服务的提供上进行范式转变。
