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约束诱导疗法或双手训练治疗儿童单侧脑瘫 1 年后疗效保持相当。

Equivalent retention of gains at 1 year after training with constraint-induced or bimanual therapy in children with unilateral cerebral palsy.

机构信息

The University of Queensland, Brisbane, Queensland, Australia.

出版信息

Neurorehabil Neural Repair. 2011 Sep;25(7):664-71. doi: 10.1177/1545968311400093. Epub 2011 Mar 22.

Abstract

OBJECTIVES

To determine retention of treatment outcomes at 52 weeks following a matched-pairs randomized comparison trial of constraint-induced movement therapy (CIMT) and bimanual training (BIM).

METHODS

Sixty-four children (mean age = 10.2 ± 2.7 years, 52% male) were included. The Melbourne Assessment of Unilateral Upper Limb Function (MUUL), Assisting Hand Assessment (AHA), and Canadian Occupational Performance Measure (COPM) were the primary outcome measures. Evaluations were at baseline and at 26 and 52 weeks.

RESULTS

There were no baseline differences between groups on any measure. No significant differences were found between groups on primary outcomes at 52 weeks. Both groups retained the significant gains made from baseline to 26 weeks at the 1-year follow-up assessment for unimanual capacity on the MUUL, for bimanual performance on the AHA, and on the COPM.

CONCLUSION

Intensive unimanual and bimanual training can both lead to long-term significant improvements in unimanual capacity, bimanual performance, and individualized outcomes. Gains established at 26 weeks were maintained at 12 months postintervention despite most children receiving no direct therapy during that time.

摘要

目的

在强制性诱导运动疗法(CIMT)和双手训练(BIM)的配对随机比较试验后 52 周,确定治疗结果的保留情况。

方法

纳入 64 名儿童(平均年龄=10.2±2.7 岁,52%为男性)。墨尔本单侧上肢功能评估(MUUL)、辅助手评估(AHA)和加拿大职业表现测量(COPM)是主要的结局评估指标。评估在基线、26 周和 52 周进行。

结果

两组在任何评估指标上均无基线差异。两组在 52 周的主要结局上均无显著差异。两组在 1 年随访时均保留了从基线到 26 周的显著改善,表现为 MUUL 的单手能力、AHA 的双手表现以及 COPM 的个体化结果。

结论

高强度的单手和双手训练都可以导致单手能力、双手表现和个体化结果的长期显著改善。尽管在此期间大多数儿童没有接受直接治疗,但在 26 周时获得的改善在干预后 12 个月仍然保持。

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