Center for Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
Neurorehabil Neural Repair. 2012 Feb;26(2):178-87. doi: 10.1177/1545968311426437. Epub 2011 Nov 9.
This is the first study to examine Wolf Motor Function Test (WMFT) tasks among EXCITE Trial participants that could not be completed at baseline or 2 weeks later.
Data were collected from participants who received constraint-induced movement therapy (CIMT) immediately at the time of randomization (CIMT-I, n = 106) and from those for whom there was a delay of 1 year in receiving this intervention (CIMT-D, n = 116). Data were collected at baseline and at a 2-week time point, during which the CIMT-I group received the CIMT intervention and the CIMT-D group did not. Generalized estimating equation (GEE) analyses were used to examine repeated binary data and count values. Group and visit interactions were assessed, adjusting for functional level, affected side, dominant side, age, and gender covariates.
In CIMT-I participants, there was an increase in the proportion of completed tasks at posttest compared with CIMT-D participants, particularly with respect to those tasks requiring dexterity with small objects and total incompletes (P < .0033). Compared with baseline, 120 tasks governing distal limb use for CIMT-I and 58 tasks dispersed across the WMFT for CIMT-D could be completed after 2 weeks. Common movement components that may have contributed to incomplete tasks include shoulder stabilization and flexion, elbow flexion and extension, wrist pronation, supination and ulnar deviation, and pincer grip.
CIMT training should emphasize therapy for those specific movement components in patients who meet the EXCITE criteria for baseline motor control.
这是第一项研究，旨在检查 EXCITE 试验参与者中无法在基线或 2 周后完成的 Wolf 运动功能测试（WMFT）任务。
数据来自立即接受强制性运动疗法（CIMT）的参与者（CIMT-I，n=106）和延迟 1 年接受此干预的参与者（CIMT-D，n=116）。数据在基线和 2 周时间点收集，在此期间，CIMT-I 组接受 CIMT 干预，而 CIMT-D 组未接受。使用广义估计方程（GEE）分析重复的二进制数据和计数值。评估了组间和访问间的交互作用，调整了功能水平、受累侧、优势侧、年龄和性别协变量。
在 CIMT-I 参与者中，与 CIMT-D 参与者相比，在测试后完成任务的比例增加，特别是在需要使用小物体进行灵巧性和总不完整的任务方面（P<.0033）。与基线相比，CIMT-I 中支配远侧肢体的 120 个任务和 CIMT-D 中分散在 WMFT 中的 58 个任务在 2 周后可以完成。可能导致未完成任务的常见运动成分包括肩部稳定和屈曲、肘部弯曲和伸展、腕部旋前、旋后和尺侧偏斜以及对掌抓握。
CIMT 训练应强调针对符合基线运动控制 EXCITE 标准的患者的那些特定运动成分进行治疗。
