Cauraugh James H, Kim Sang-Bum, Summers Jeffery J
Motor Behavior Laboratory, Center for Exercise Science, University of Florida, Gainesville, FL 32611, USA.
Cerebrovasc Dis. 2008;25(1-2):115-21. doi: 10.1159/000112321. Epub 2007 Dec 11.
The purpose was to determine the cumulative longitudinal effects of upper extremity distributed practice with variable treatment protocols involving EMG-triggered neuromuscular stimulation and coupled bilateral movements.
Sixteen chronic stroke subjects were randomly selected to complete 5 effective upper extremity treatment protocols over 12 months. The subjects were randomly assigned to 1 of 2 treatment orders. Consistent across the orders and protocols, the participants completed 90 min of training per day for 4 days during separate 2-week rehabilitation periods.
Data for the 5 primary outcome measures were analyzed in separate mixed design ANOVAs (treatment order x test session: 2 x 6). The analyses revealed distinct cumulative treatment evidence later in training in comparison to the baseline motor capabilities: (1) higher number of blocks moved; (2) higher percentage of blocks moved by the impaired hand; (3) faster motor reaction time (peripheral component), and (4) faster total reaction time.
These chronic stroke patients displayed robust cumulative motor improvement effects from the longitudinally distributed practice of active neuromuscular stimulation and coupled bilateral movements.
目的是确定采用涉及肌电图触发神经肌肉刺激和双侧耦合运动的可变治疗方案进行上肢分布式练习的累积纵向效果。
随机选择16名慢性中风患者，在12个月内完成5种有效的上肢治疗方案。受试者被随机分配到2种治疗顺序中的1种。在所有顺序和方案中保持一致的是，参与者在单独的2周康复期内，每天进行90分钟的训练，共4天。
对5项主要结局指标的数据进行了单独的混合设计方差分析（治疗顺序×测试时段：2×6）。分析显示，与基线运动能力相比，训练后期有明显的累积治疗证据：（1）移动的积木数量更多；（2）受损手移动的积木百分比更高；（3）运动反应时间更快（外周成分），以及（4）总反应时间更快。
这些慢性中风患者通过主动神经肌肉刺激和双侧耦合运动的纵向分布式练习，表现出强大的累积运动改善效果。
