Stewart Kim C, Cauraugh James H, Summers Jeffery J
University of Florida, Gainesville, Florida 32611, USA.
J Neurol Sci. 2006 May 15;244(1-2):89-95. doi: 10.1016/j.jns.2006.01.005. Epub 2006 Feb 14.
Bilateral movement training is being increasingly used as a post-stroke motor rehabilitation protocol. The contemporary emphasis on evidence-based medicine warrants a prospective meta-analysis to determine the overall effectiveness of rehabilitating with bilateral movements.
After searching reference lists of bilateral motor recovery articles as well as PubMed and Cochrane databases, 11 stroke rehabilitation studies qualified for this systematic review. An essential requirement for inclusion was that the bilateral training protocols involved either functional tasks or repetitive arm movements. Each study had one of three common arm and hand functional outcome measures: Fugl-Meyer, Box and Block, and kinematic performance.
The fixed effects model primary meta-analysis revealed an overall effect size (ES=0.732, S.D.=0.13). These findings indicate that bilateral movement training was beneficial for improving motor recovery post-stroke. Moreover, a fail-safe analysis indicated that 48 null effects would be necessary to lower the mean effect size to an insignificant level.
These meta-analysis findings indicate that bilateral movements alone or in combination with auxiliary sensory feedback are effective stroke rehabilitation protocols during the sub-acute and chronic phases of recovery.
双侧运动训练越来越多地被用作中风后的运动康复方案。当代对循证医学的重视使得有必要进行一项前瞻性荟萃分析，以确定双侧运动康复的总体效果。
在检索双侧运动恢复文章的参考文献列表以及PubMed和Cochrane数据库后，有11项中风康复研究符合该系统评价的要求。纳入的一个基本要求是双侧训练方案涉及功能性任务或重复性手臂运动。每项研究都采用以下三种常见的手臂和手部功能结局测量方法之一：Fugl-Meyer评估法、方块积木测试和运动学表现。
固定效应模型的主要荟萃分析显示总体效应量（ES = 0.732，标准差 = 0.13）。这些结果表明，双侧运动训练有利于改善中风后的运动恢复。此外，失安全分析表明，需要48个无效效应才能将平均效应量降低到无显著意义的水平。
这些荟萃分析结果表明，在恢复的亚急性期和慢性期，单独的双侧运动或与辅助感觉反馈相结合都是有效的中风康复方案。
