Motor Behavior Laboratory, Center for Exercise Science, University of Florida, Gainesville, Florida 32611, USA.
Hum Mov Sci. 2010 Oct;29(5):853-70. doi: 10.1016/j.humov.2009.09.004. Epub 2009 Nov 18.
The purpose was to conduct a structured review and meta-analysis to determine the cumulative effect of bilateral arm training on motor capabilities post stroke. Forty-eight stroke studies were selected from three databases with 25 comparisons qualifying for inclusion in our meta-analysis. We identified and coded four types of bilateral arm interventions with 366 stroke patients. A random effects model using the standardized mean difference technique determined a large and significant effect size (0.734; SE=0.125), high fail-safe N (532), and medium variability in the studies (I(2)=63%). Moderator variable analysis on the type of bilateral training revealed two large and significant effects: (a) BATRAC (0.842; SE=0.155) and (b) coupled bilateral and EMG-triggered neuromuscular stimulation (1.142; SE=0.176). These novel findings provide strong evidence supporting bilateral arm training with the caveat that two coupled protocols, rhythmic alternating movements and active stimulation, are most effective.
目的是进行系统回顾和荟萃分析，以确定脑卒中后双侧手臂训练对运动能力的累积效应。从三个数据库中选择了 48 项脑卒中研究，其中 25 项符合纳入荟萃分析的标准。我们确定并编码了 4 种双侧手臂干预类型，涉及 366 名脑卒中患者。使用标准化均数差技术的随机效应模型确定了较大且显著的效应量（0.734；SE=0.125）、较高的失效安全 N（532）和研究中中等的变异性（I²=63%）。对双侧训练类型的调节变量分析显示了两个较大且显著的效应：（a）BATRAC（0.842；SE=0.155）和（b）耦合双侧和肌电图触发神经肌肉刺激（1.142；SE=0.176）。这些新发现提供了强有力的证据支持双侧手臂训练，但需要注意的是，两种耦合方案，即节律性交替运动和主动刺激，最为有效。
