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限制诱导疗法与剂量匹配对照干预对改善中风患者运动能力、基本/扩展日常生活功能及生活质量的研究

Constraint-induced therapy versus dose-matched control intervention to improve motor ability, basic/extended daily functions, and quality of life in stroke.

作者信息

Lin Keh-chung, Wu Ching-yi, Liu Jung-sen, Chen Yueh-tsen, Hsu Chen-jung

机构信息

School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Neurorehabil Neural Repair. 2009 Feb;23(2):160-5. doi: 10.1177/1545968308320642. Epub 2008 Nov 3.

Abstract

BACKGROUND

Trials of constraint-induced movement therapy (CIT) to improve upper extremity function after stroke have usually not included an actively treated control group.

OBJECTIVE

This study compared a modified CIT intervention with a dose-matched control intervention that included restraint of the less affected hand and assessed for differences in motor and functional performance and health-related quality of life.

METHODS

This 2-group randomized controlled trial, using pretreatment and posttreatment measures, enrolled 32 patients within 6 to 40 months after onset of a first stroke (mean age, 55.7 years). They received either CIT (restraint of the less affected limb combined with intensive training of the affected limb for 2 hours daily 5 days per week for 3 weeks and restraint of the less affected hand for 5 hours outside of the rehabilitation training) or a conventional intervention with hand restraint for the same duration. Outcome measures were the Fugl-Meyer Assessment, Functional Independence Measure, Motor Activity Log, Nottingham Extended Activities of Daily Living Scale, and Stroke Impact Scale.

RESULTS

Compared with the control group, the CIT group exhibited significantly better performance in motor function, level of functional independence, mobility of extended activities during daily life, and health-related quality of life after treatment.

CONCLUSIONS

The robust effects of this form of CIT were demonstrated in various aspects of outcome, including motor function, basic and extended functional ability, and quality of life.

摘要

背景

旨在改善中风后上肢功能的强制性运动疗法(CIT)试验通常未纳入积极治疗的对照组。

目的

本研究将改良的CIT干预与剂量匹配的对照干预进行比较,后者包括对受影响较小的手进行约束,并评估运动和功能表现以及与健康相关的生活质量方面的差异。

方法

这项两组随机对照试验采用治疗前和治疗后测量,纳入了32例首次中风发病后6至40个月内的患者(平均年龄55.7岁)。他们接受了CIT(对受影响较小的肢体进行约束,并结合对受影响肢体进行强化训练,每周5天,每天2小时,共3周,以及在康复训练之外对受影响较小的手进行5小时约束)或相同持续时间的手部约束常规干预。结果测量指标包括Fugl-Meyer评估、功能独立性测量、运动活动日志、诺丁汉日常生活扩展活动量表和中风影响量表。

结果

与对照组相比,CIT组在治疗后的运动功能、功能独立水平、日常生活中扩展活动的灵活性以及与健康相关的生活质量方面表现明显更好。

结论

这种形式的CIT在包括运动功能、基本和扩展功能能力以及生活质量等结果的各个方面都显示出显著效果。

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