VO Paramedicin, Södertälje Sjukhus, Södertälje, Sweden.
Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden.
Top Stroke Rehabil. 2014 Mar-Apr;21(2):111-9. doi: 10.1310/tsr2102-111.
Studies have demonstrated improvements in arm motor function after constraint-induced (CI) therapy. Few studies of CI therapy for lower extremity conditions have been done. Our purpose was to evaluate the effect of modified CI therapy for the lower extremity in terms of motor control in elderly persons with chronic stroke.
A single-subject experimental AB design was used, with 3 months of follow-up. The A phase consisted of a baseline period of 2 weeks with 6 measurements, and the B phase was a 4-week intervention with 8 measurements. Two men and 1 woman were included. The intervention consisted of intensive rehabilitation of the affected leg for 2 hours each weekday. A whole-leg orthosis was used to immobilize the nonaffected leg. The following tests were conducted: a step test for dynamic balance, Fugl-Meyer assessment for lower-extremity motor function, the Timed Up and Go test for mobility, and the 6-minute and 10-meter walk tests for walking ability. Statistical significance was analyzed by using Shewhart charts with a 2-standard deviation band method.
A positive change was observed in 14 of 18 variables. Significant improvements existed in 7 of the 14 positively changed variables. Positive changes remained in 13 of 14 variables at the 3-month follow-up evaluation.
Modified CI therapy may result in positive changes in balance and motor function in elderly persons with chronic stroke.
研究表明，约束诱导（CI）疗法可改善上肢运动功能。针对下肢疾病的 CI 疗法研究较少。我们的目的是评估改良的 CI 疗法对慢性脑卒中老年人下肢运动控制的影响。
采用单病例实验 AB 设计，随访 3 个月。A 阶段包括基线期 2 周，共进行 6 次测量；B 阶段为 4 周干预期，共进行 8 次测量。纳入 2 名男性和 1 名女性。干预包括每周 5 天每天 2 小时对患侧下肢进行强化康复，使用全腿矫形器固定健侧下肢。进行了以下测试：动态平衡的踏步测试、下肢运动功能的 Fugl-Meyer 评估、移动能力的计时起立行走测试、步行能力的 6 分钟和 10 米步行测试。使用 Shewhart 图表和 2 个标准差带法进行统计显著性分析。
18 个变量中有 14 个发生了积极变化。在 14 个正向变化的变量中，有 7 个存在显著改善。在 3 个月的随访评估中，14 个变量中有 13 个保持了积极变化。
改良的 CI 疗法可能会导致慢性脑卒中老年人平衡和运动功能的积极变化。
