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急性中风后下肢感觉再训练:一项随机对照试验性研究

Sensory retraining of the lower limb after acute stroke: a randomized controlled pilot trial.

作者信息

Lynch Elizabeth A, Hillier Susan L, Stiller Kathy, Campanella Rachel R, Fisher Penny H

机构信息

Hampstead Rehabilitation Centre, Adelaide, Centre for Allied Health Evidence, University of South Australia, and Royal Adelaide Hospital, South Australia, Australia.

出版信息

Arch Phys Med Rehabil. 2007 Sep;88(9):1101-7. doi: 10.1016/j.apmr.2007.06.010.

Abstract

OBJECTIVE

To determine the effects of a sensory retraining protocol on sensation, postural control, and gait in acute stroke subjects.

DESIGN

Randomized controlled pilot trial.

SETTING

Inpatient rehabilitation hospital.

PARTICIPANTS

Twenty-one subjects with sensory deficits in the feet, undergoing rehabilitation for stroke.

INTERVENTION

Sensory retraining of the more affected lower limb versus relaxation (sham intervention).

MAIN OUTCOME MEASURES

Light touch at the sole of the foot (Semmes-Weinstein monofilaments), proprioception (Distal Proprioception Test), postural control (Berg Balance Scale), and gait (timed, Iowa Level of Assistance Scale).

RESULTS

Significant improvements (P<.05) over time were found in light touch at 3 points of the feet and in postural control, timed gait, and walking aid. No significant time effects were observed in proprioception or amount of assistance required to walk. No significant differences were detected between groups in any of the outcome variables, apart from light touch at the first metatarsal. The study had poor power (13%) to detect group effects due to the small sample size.

CONCLUSIONS

Results of this pilot study are unable to support or refute the routine use of sensory retraining of the lower limb for people during inpatient rehabilitation after stroke. Further research with a larger sample size is required.

摘要

目的

确定感觉再训练方案对急性中风患者的感觉、姿势控制和步态的影响。

设计

随机对照试验。

地点

住院康复医院。

参与者

21名足部存在感觉缺陷且正在接受中风康复治疗的患者。

干预措施

对受影响更严重的下肢进行感觉再训练,与放松(假干预)进行对比。

主要观察指标

足底轻触觉(Semmes-Weinstein单丝)、本体感觉(远端本体感觉测试)、姿势控制(伯格平衡量表)和步态(定时、爱荷华州辅助水平量表)。

结果

随着时间推移,足部3个点的轻触觉、姿势控制、定时步态和步行辅助方面有显著改善(P<0.05)。本体感觉或行走所需辅助量未观察到显著的时间效应。除第一跖骨处的轻触觉外,各结局变量在两组间均未检测到显著差异。由于样本量小,该研究检测组间效应的效能较低(13%)。

结论

这项初步研究的结果无法支持或反驳在中风后住院康复期间对患者常规使用下肢感觉再训练。需要进行更大样本量的进一步研究。

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