Page Stephen J
Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, Ohio 45267, USA.
Am J Phys Med Rehabil. 2003 Sep;82(9):730-2. doi: 10.1097/01.PHM.0000078226.36000.A5.
Recent evidence suggests that intense training regimens can increase the use and function of the more affected limbs of stroke patients. The efficacy of these intense regimens has led some to conclude that intense training regimens should be more widely applied clinically and has caused some physicians to attempt implementation of more intense training regimens with stroke patients. However, intense protocols may not be needed to produce positive motor changes in some patients and may not be plausible in some environments or with some patients. In this commentary, we review the evidence supporting the efficacy of less intense, task-specific training regimens emphasizing the use of the more affected limb. We submit that intensity does not need to be altered to induce substantial clinical improvements, as some have suggested. Rather, the results of the studies suggest that the nature of stroke motor therapy itself can be altered to be more task-specific while remaining within the typical contact time parameters (i.e., 30-45 min/session), yet can be more efficacious than more traditional motor rehabilitative approaches.
最近的证据表明，强化训练方案可以增加中风患者受影响更严重肢体的使用和功能。这些强化方案的有效性使得一些人得出结论，认为强化训练方案应在临床上更广泛地应用，并且导致一些医生尝试对中风患者实施更强化的训练方案。然而，在某些患者中可能不需要强化方案就能产生积极的运动变化，而且在某些环境或某些患者中可能也不可行。在这篇评论中，我们回顾了支持强度较低、针对特定任务的训练方案有效性的证据，这些方案强调使用受影响更严重的肢体。我们认为，并不需要像一些人所建议的那样改变强度来实现显著的临床改善。相反，研究结果表明，中风运动疗法本身的性质可以改变，使其更具任务特异性，同时保持在典型的接触时间参数范围内（即每次治疗30 - 45分钟），但比更传统的运动康复方法更有效。
