Page Stephen J, Levine Peter
Department of Physical Medicine and Rehabilitation, University of Cincinnati Academic Medical Center, Cincinnati, OH 45267, USA.
Arch Phys Med Rehabil. 2007 Jul;88(7):922-7. doi: 10.1016/j.apmr.2007.03.038.
To determine efficacy of a modified constraint-induced therapy extension (mCITE) protocol, in which persons with stroke participated in therapy sessions via the Internet.
Pre-post, single-blinded case series.
Outpatient clinic.
Four people with stroke who experienced stroke more than 1 year prior to study entry exhibiting upper-limb hemiparesis and nonuse.
Subjects participated in online, 30-minute therapy sessions, 3 times a week for 10 weeks using personal computer-based cameras and free network meeting software. During the same period, subjects' less affected hands and wrists were restrained every weekday for 5 hours. Patients completed online logs to document restraint use and activities practiced at home.
The Motor Activity Log (MAL) and Wolf Motor Function Test (WMFT). We also used a structured interview to ask patients about their satisfaction with the protocol.
After intervention, subjects exhibited marked improvements in more affected arm use (+2.7, +2.06, +1.7, +2,83, respectively), quality of movement (+2.1, +2.1, +2.03, +1.9, respectively), as measured by the MAL, and speed increases while performing WMFT tasks. Subjects' mCITE satisfaction and adherence were high, and motor changes translated to ability to perform valued activities.
A home-based, modified constraint-induced movement therapy program is feasible and appears to increase more affected arm use and function using commercially available, inexpensive technologies.
确定改良的强制性诱导疗法扩展方案(mCITE)的疗效,该方案让中风患者通过互联网参与治疗课程。
前后对照、单盲病例系列。
门诊诊所。
4名中风患者,在研究入组前1年多发生中风,表现为上肢偏瘫和废用。
受试者使用个人电脑摄像头和免费网络会议软件,每周进行3次、每次30分钟的在线治疗课程,持续10周。在此期间,受试者受影响较小的手和手腕在每个工作日被约束5小时。患者完成在线日志,记录约束使用情况和在家中练习的活动。
运动活动日志(MAL)和沃尔夫运动功能测试(WMFT)。我们还通过结构化访谈询问患者对该方案的满意度。
干预后,通过MAL测量,受试者受影响较大的手臂使用情况(分别提高2.7、2.06、1.7、2.83)、运动质量(分别提高2.1、2.1、2.03、1.9)有显著改善,并且在执行WMFT任务时速度增加。受试者对mCITE的满意度和依从性较高,运动变化转化为执行有价值活动的能力。
基于家庭的改良强制性诱导运动疗法方案是可行的,并且似乎可以使用市售的廉价技术增加受影响较大手臂的使用和功能。