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基于任务的镜像疗法对慢性脑卒中患者上肢运动功能恢复的影响:一项初步研究。

Effect of task-based mirror therapy on motor recovery of the upper extremity in chronic stroke patients: a pilot study.

机构信息

Pt. Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice & Empowerment, Government of India, New Delhi, India.

出版信息

Top Stroke Rehabil. 2013 May-Jun;20(3):210-7. doi: 10.1310/tsr2003-210.

Abstract

BACKGROUND AND AIMS

Mirror therapy (MT) is an alternative therapeutic intervention that uses the interaction of visuomotor-proprioception inputs to enhance movement performance of the impaired limb. Despite strong evidence for task-specific training in stroke, MT has been investigated using nontask movements. The aim of this pilot study was to assess the effectiveness of task-based MT on motor recovery of the upper extremity in chronic stroke patients.

METHOD

In a pretest-posttest single-group design, a convenience sample of 13 chronic stroke patients at an occupational therapy department of a rehabilitation institute was assessed on a task-based MT intervention. Participants received a task-based MT program, performing various tasks by the less affected upper extremity and observing in the mirror box along with conventional management, 4 days per week for 4 weeks. Fugl-Meyer Assessment (FMA), which includes subsection upper extremity (FMA-UE) and subpart upper arm (FMA-UA) and hand (FMA-WH), was used as an outcome measure.

RESULTS

Participants showed no significant improvement for FMA-UE and FMA-UA at postassessment. FMA-UE changed from 43% to 51%. Post FMA-UA score showed only 2% improvement. However, there was statistically significant improvement on mean scores of FMA-WH at postassessment (16.21 ± 3.06) as compared with the prescores (12.29 ± 3.1; P < .05). FMA-WH improved from 41% to 54%.

CONCLUSIONS

The preliminary findings suggest that task-based MT is effective in improving wrist and hand motor recovery in chronic stroke patients. Further studies in the form of randomized trials are needed to validate its effectiveness.

摘要

背景与目的

镜像疗法(MT)是一种替代治疗干预措施,利用视动本体感觉输入的相互作用来增强受损肢体的运动表现。尽管有强烈的证据表明运动任务特异性训练在中风中有效,但 MT 已经被用于非任务运动的研究。本研究旨在评估基于任务的 MT 对慢性中风患者上肢运动功能恢复的有效性。

方法

采用预测试-后测试单组设计,对康复研究所职业治疗部门的 13 例慢性中风患者进行基于任务的 MT 干预评估。参与者接受基于任务的 MT 计划,通过非患侧上肢执行各种任务,并在镜子盒子里观察,同时进行常规管理,每周 4 天,持续 4 周。采用 Fugl-Meyer 评估(FMA),包括上肢部分(FMA-UE)和上臂部分(FMA-UA)和手部分(FMA-WH),作为评估结果。

结果

参与者在后期评估中 FMA-UE 和 FMA-UA 没有显著改善。FMA-UE 从 43%增加到 51%。FMA-UA 的后期评分仅提高了 2%。然而,后期 FMA-WH 的平均评分(16.21±3.06)与前期评分(12.29±3.1;P<.05)相比有统计学显著改善。FMA-WH 从 41%提高到 54%。

结论

初步结果表明,基于任务的 MT 对改善慢性中风患者腕部和手部运动功能恢复是有效的。需要进一步的随机试验研究来验证其有效性。

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