Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.
Phys Ther. 2012 Apr;92(4):483-92. doi: 10.2522/ptj.20110213. Epub 2012 Jan 6.
Studies have suggested that constraint-induced therapy combined with trunk restraint (CIT-TR) improves arm movement and reduces trunk compensation. Whether participants who receive CIT-TR can translate the benefits to real-life circumstances awaits further investigation.
The effects of distributed CIT-TR (dCIT-TR) on motor function, daily function, quality of life (QOL), and arm-trunk control were investigated.
The study was a single-blind, randomized controlled trial.
The study took place at 4 hospitals.
Participants were 57 people who had had a stroke 6 to 55 months earlier.
Participants received a dose-matched intervention (2 hours per day, 5 days per week, for 3 weeks) of dCIT-TR, distributed constraint-induced therapy (dCIT), or control therapy.
The Action Research Arm Test (ARAT), Motor Activity Log, Frenchay Activities Index (FAI), and Stroke Impact Scale (SIS) were used to evaluate motor function, daily function, and QOL. Data for reaching kinematics were recorded.
Participants receiving dCIT-TR and dCIT exhibited higher overall scores on the ARAT, FAI, and hand function domain of the SIS and better quality of movement and larger amount of use (of the affected arm) on the Motor Activity Log than participants in the control group. Participants receiving dCIT-TR further demonstrated greater improvements on the ARAT grip subscale and FAI outdoor activities scale than participants receiving dCIT or participants in the control group. However, participants receiving dCIT showed greater improvements on the strength domain of the SIS after training than participants receiving dCIT-TR or participants in the control group. Limitations Research with a larger sample size is needed.
Participants who received dCIT-TR were able to translate gains in arm-trunk control into functional performance and QOL, specifically in grip function and outdoor activities. A long-term study to examine the recovery course for force output may be needed to evaluate people's perception of less improvement in strength after dCIT-TR.
研究表明，强制性诱导疗法结合躯干约束（CIT-TR）可改善手臂运动并减少躯干代偿。尚需进一步研究接受 CIT-TR 的参与者能否将获益转化到实际生活环境中。
研究分布式强制性诱导疗法（dCIT-TR）对运动功能、日常功能、生活质量（QOL）和手臂-躯干控制的影响。
单盲、随机对照试验。
研究在 4 家医院进行。
57 名卒中后 6 至 55 个月的参与者。
参与者接受剂量匹配的干预（每天 2 小时，每周 5 天，共 3 周），包括 dCIT-TR、分布式强制性诱导疗法（dCIT）或对照治疗。
使用动作研究手臂测试（ARAT）、运动活动日志、Frenchay 活动指数（FAI）和卒中影响量表（SIS）评估运动功能、日常功能和 QOL。记录到达运动学数据。
与对照组相比，接受 dCIT-TR 和 dCIT 的参与者在 ARAT、FAI 和 SIS 的手功能域的总分更高，运动质量更好，使用（患侧手臂）更多，运动活动日志的活动量更大。接受 dCIT-TR 的参与者在 ARAT 握力子量表和 FAI 户外活动量表的改善程度大于接受 dCIT 或对照组的参与者。然而，与接受 dCIT-TR 或对照组的参与者相比，接受 dCIT 的参与者在 SIS 的力量域的改善程度更大。
需要更大样本量的研究。
接受 dCIT-TR 的参与者能够将手臂-躯干控制的改善转化为功能表现和 QOL，特别是在握力功能和户外活动方面。为了评估人们对 dCIT-TR 后力量输出改善程度较低的感知，可能需要进行一项长期研究来观察力输出的恢复过程。
