Wolf Steven L, Blanton Sarah, Baer Heather, Breshears Jenifer, Butler Andrew J
Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Neurologist. 2002 Nov;8(6):325-38. doi: 10.1097/01.nrl.0000031014.85777.76.
Constraint-induced (CI) movement therapy (also called forced use by some investigators and clinicians) has gained increasing popularity as a treatment mode for restoring function in the upper extremities of patients with stroke. The purpose of this article is to review the concept of constraint-induced movement therapy and provide a critical analysis of the existing data.
The evidence to date offers encouragement for the application of this procedure for patients who have some movement recovery out of synergy. Success may be contingent on patient cooperation and intense repetitive use with applications of retraining through practice and shaping. The extent to which each of the latter elements influences the magnitude of recovery is still unclear. However, task novelty and challenge seem important to recovery of function. There are several methods used to map cortical changes after stroke. At this time, transcranial magnetic stimulation is the primary vehicle used to assess motor cortical reorganization after CI therapy in humans.
Accumulating data indicate that the size of a cortical area representative of a muscle does expand and its center of gravity does change with CI therapy.
强制性诱导（CI）运动疗法（一些研究者和临床医生也称之为强制使用疗法）作为一种恢复中风患者上肢功能的治疗方式，越来越受到欢迎。本文旨在回顾强制性诱导运动疗法的概念，并对现有数据进行批判性分析。
迄今为止的证据为将该疗法应用于有部分脱离协同运动恢复的患者提供了支持。成功可能取决于患者的配合以及通过练习和塑形进行再训练的强化重复使用。后述各要素对恢复程度的影响仍不明确。然而，任务的新颖性和挑战性似乎对功能恢复很重要。有几种方法用于绘制中风后的皮质变化。目前，经颅磁刺激是评估人类CI治疗后运动皮质重组的主要手段。
越来越多的数据表明，代表一块肌肉的皮质区域大小在CI治疗后确实会扩大，其重心也会改变。
