School of Allied Medical Professions, Division of Occupational Therapy, The Ohio State University, 406 Atwell Hall, 453 West Tenth Avenue, Columbus, OH 43210, USA.
Am J Occup Ther. 2011 Sep-Oct;65(5):589-93. doi: 10.5014/ajot.2011.000513.
The practicality and patient compliance of constraint-induced movement therapy limit its application in many clinical environments. For more than a decade, the principal investigator's laboratory has shown efficacy of an outpatient, modified constraint-induced therapy (mCIT). The current study examined whether participants administered mCIT retained motor changes 3 mo after intervention. The upper-extremity section of the Fugl-Meyer Impairment Scale (FM) and the Action Research Arm Test (ARA) were administered directly after mCIT intervention. Thirteen patients poststroke were tracked prospectively from directly after intervention concluded to 3 mo after intervention, at which time the FM and ARA were readministered. Three months after intervention, 25 of the 26 scores on the FM and ARA increased between the time after intervention and 3 months after intervention, reflecting continued increases in affected extremity movement ability. It is believed that the continued motor changes were caused by the comparatively larger number of extremity-use opportunities during the 10-wk mCIT intervention period. These opportunities encourage habitual extremity use even after the intervention period has concluded, leading to the changes observed.
强制性运动疗法的实用性和患者依从性限制了其在许多临床环境中的应用。十多年来,主要研究者的实验室已经证明了门诊改良强制性运动疗法(mCIT)的有效性。本研究旨在探讨接受 mCIT 治疗的参与者在干预后 3 个月是否仍能保持运动功能的改善。在 mCIT 干预结束后直接进行上肢 Fugl-Meyer 运动功能评定量表(FM)和上肢动作研究测试(ARA)的评定。13 例脑卒中患者在干预结束后直接进行前瞻性随访,直到干预结束后 3 个月,此时再次进行 FM 和 ARA 的评定。干预结束后 3 个月,FM 和 ARA 的 26 项评分中有 25 项在干预后和 3 个月后的评分之间有所增加,这反映了患侧肢体运动能力的持续提高。研究者认为,这是由于在为期 10 周的 mCIT 干预期间,患者有更多的使用肢体的机会,从而导致了持续的运动功能改善。这些机会鼓励患者在干预结束后习惯性地使用肢体,从而导致了所观察到的变化。