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左上肢体感刺激联合视觉扫描训练用于脑卒中后偏侧空间忽视的康复治疗:一项随机双盲研究

Left-hand somatosensory stimulation combined with visual scanning training in rehabilitation for post-stroke hemineglect: a randomised, double-blind study.

作者信息

Polanowska Katarzyna, Seniów Joanna, Paprot Ewa, Leśniak Marcin, Członkowska Anna

机构信息

2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.

出版信息

Neuropsychol Rehabil. 2009 Jun;19(3):364-82. doi: 10.1080/09602010802268856. Epub 2008 Jul 1.

Abstract

The aim of this randomised, double-blind study was to investigate the therapeutic effectiveness of left-hand electrical stimulation for patients with post-stroke left visuo-spatial neglect. This approach was hypothesised to enhance activation of the right hemisphere attention system and to improve visual exploration of extrapersonal space. Participants (n = 40) in the study were in a relatively early stage of recovery from their first right hemisphere stroke, and were randomly assigned to the experimental (E) or control (C) group. Group E received conventional visual scanning training combined with electrostimulation of the left hand, while Group C received scanning training with sham stimulation. Their visuo-spatial neglect was assessed twice, prior to the rehabilitation programme and on its completion, using cancellation tests and a letter-reading task. The effect of electrostimulation on hemineglect was assessed following a single administration and after a month-long rehabilitation programme. Although the immediate effect of stimulation was poor, after a month-long rehabilitation period we found significantly greater improvement in Group E patients than in Group C patients. Interestingly, the presence of hemisensory loss did not weaken the observed effect. Therefore, we claim that contralesional hand stimulation combined with visual scanning was a more effective treatment for hemineglect rehabilitation than scanning training alone.

摘要

这项随机双盲研究的目的是调查左手电刺激对中风后左侧视觉空间忽视患者的治疗效果。该方法的假设是增强右半球注意力系统的激活,并改善对个人空间外视觉空间的探索。研究中的参与者(n = 40)处于首次右半球中风恢复的相对早期阶段,并被随机分配到实验组(E)或对照组(C)。E组接受传统视觉扫描训练并结合左手电刺激,而C组接受假刺激的扫描训练。在康复计划之前和完成时,使用划消测试和字母阅读任务对他们的视觉空间忽视进行了两次评估。在单次给药后和为期一个月的康复计划后,评估了电刺激对偏侧忽视的影响。尽管刺激的即时效果不佳,但经过一个月的康复期后,我们发现E组患者的改善明显大于C组患者。有趣的是,偏侧感觉丧失的存在并没有削弱观察到的效果。因此,我们认为对侧手刺激结合视觉扫描比单独的扫描训练是一种更有效的偏侧忽视康复治疗方法。

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