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中风后中度慢性上肢功能障碍的强制性诱导疗法

Constraint-induced therapy for moderate chronic upper extremity impairment after stroke.

作者信息

Bonifer N M, Anderson K M, Arciniegas D B

机构信息

Spaulding Rehabilitation Hospital, Aurora, Colorado 80011, USA.

出版信息

Brain Inj. 2005 May;19(5):323-30. doi: 10.1080/02699050400004302.

Abstract

PRIMARY OBJECTIVE

To explore the effectiveness of constraint-induced therapy (CIT) in the treatment of individuals with moderate chronic upper extremity paresis.

RESEARCH DESIGN

Multiple case reports, pre-post-treatment comparisons as well as long-term follow-ups at 1 and 6 months after intervention.

METHODS AND PROCEDURES

Seven subjects, each greater than 12 months post-stroke, participated in an intensive 3 weeks CIT programme. The Wolf Motor Function Test (WMFT), Motor Activity Log (MAL) and Fugl-Meyer Evaluation (FM) were used to measure outcomes.

MAIN OUTCOMES AND RESULTS

Subjects exhibited notable improvements in mean WMFT scores (0.25 point increase post-treatment, 0.38 point increase at 1-month follow-up, 0.44 point increase at 6-month follow-up). Similarly, improvements were seen for mean MAL (1.71 points for AS, 1.77 points for HW) and FM scores (6 points FM-UE, 6 points FM-TOT) post-treatment. Additional improvements were seen at some follow-up assessments.

CONCLUSIONS

Subjects demonstrated gains in objective measures, however, did not regain normal functional ability of their paretic upper extremities. Further investigation of the effects of CIT in this population, as well the functional significance of the objective measures used is warranted.

摘要

主要目的

探讨强制性运动疗法(CIT)对中度慢性上肢轻瘫患者的治疗效果。

研究设计

多例病例报告、治疗前后对比以及干预后1个月和6个月的长期随访。

方法与步骤

7名中风后超过12个月的受试者参加了为期3周的强化CIT项目。采用Wolf运动功能测试(WMFT)、运动活动日志(MAL)和Fugl-Meyer评估(FM)来测量结果。

主要结果

受试者的平均WMFT评分有显著改善(治疗后增加0.25分,1个月随访时增加0.38分,6个月随访时增加0.44分)。同样,治疗后平均MAL(AS增加1.71分,HW增加1.77分)和FM评分(FM-UE增加6分,FM-TOT增加6分)也有改善。在一些随访评估中还观察到进一步的改善。

结论

受试者在客观测量中有所改善,然而,其瘫痪上肢并未恢复正常功能能力。有必要进一步研究CIT对该人群的影响以及所用客观测量的功能意义。

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