Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL.
Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL.
Arch Phys Med Rehabil. 2014 Aug;95(8):1571-6. doi: 10.1016/j.apmr.2014.04.008. Epub 2014 May 2.
To investigate the longevity and cumulative impact of multiple sessions of passive, cyclical stretching of the digits on hand function in subacute stroke survivors.
Before-after trial with intervention repeated on 3 consecutive days.
Research laboratory.
Individuals (N=27) with moderate to severe hand impairment, 2 to 6 months (subacute, n=12) and >7 months (chronic, n=15) poststroke.
Subjects wore an actuated glove orthosis that cyclically moved their fingers and thumb from a relaxed/flexed posture into neutral extension for 30 minutes on 3 consecutive days.
Three hand-specific tasks from the Graded Wolf Motor Function Test, Box and Block Test (BBT), grip strength, and lateral pinch strength. Recordings were taken before stretching and at 3 time points, each separated by 30 minutes after completion of stretching on each day.
Significant improvement was observed immediately after the stretching for both groups. Improvements in the subacute group were largely maintained up to 1 hour poststretching, with significant carryover from day to day for some outcomes measures such as the BBT (P=.006) and grip strength (P=.012). In contrast, improvements after stretching for the chronic group were transient, with the changes largely dissipating over time and no significant cumulative effect across days.
Cyclical stretching of the digits had a lasting and reinforcing effect on improving hand motor control for subacute stroke survivors. Incorporation of cyclical stretching before active hand therapy may prove to be a beneficial treatment for stroke survivors, especially during the subacute phase of recovery.
研究多次被动、循环牵拉手指对手部功能的长期影响和累积效应，以改善亚急性脑卒中幸存者的手部功能。
干预前后，连续 3 天重复进行试验。
研究实验室。
27 名中度至重度手部功能障碍的个体，发病后 2 至 6 个月（亚急性期，n=12）和>7 个月（慢性期，n=15）。
受试者佩戴可主动活动的手套矫形器，连续 3 天，每天 30 分钟，使手指和拇指从放松/弯曲姿势被动循环移动到中立伸展位置。
从分级沃尔夫运动功能测试（Graded Wolf Motor Function Test）、方块-箱测试（Box and Block Test，BBT）、握力和侧捏力中选取 3 项手部特定任务进行评估。在拉伸前和拉伸后 30 分钟的 3 个时间点进行记录。
两组患者在拉伸后即刻均有显著改善。亚急性期患者的改善在拉伸后 1 小时内基本保持，一些结果指标（如 BBT，P=.006；握力，P=.012）具有显著的日间持续效果。相比之下，慢性期患者拉伸后的改善是短暂的，随着时间的推移，这些变化逐渐消散，并且没有明显的累加效应。
手指的循环牵拉对改善亚急性脑卒中幸存者的手部运动控制具有持久的强化作用。在主动手部治疗之前加入循环牵拉可能是一种有益的治疗方法，尤其是在脑卒中康复的亚急性期。
