Sale Patrizio, Ceravolo Maria Gabriella, Franceschini Marco
Department of Neurorehabilitation, IRCCS San Raffaele Pisana, Via Della Pisana 235, 00163 Rome, Italy.
Department of Experimental and Clinical Medicine, Polytechnic University of Marche, 60121 Ancona, Italy.
Biomed Res Int. 2014;2014:457538. doi: 10.1155/2014/457538. Epub 2014 May 22.
The clinical impact of action observation (AO) on upper limb functional recovery in subacute stroke patients is recent evidence. We sought to test the hypothesis that training everyday life activities through AO coupled with task execution might activate the left hemisphere different from the right one. Sixty-seven first-ever ischemic stroke subjects were randomly assigned to receive upper limb training coupled with AO tasks or standard rehabilitation. The groups were matched by age and gender, Bamford category, and interval from stroke and lesion side. Fugl-Meyer (FM) and Box and Block Test (BBT) were used to measure hand function recovery at the end (T1) and 4-5 months after the treatment (T2). At T1, FM was increased by 31% (± 26%), of maximum achievable recovery, whereas BBT was increased by 17% (± 18%); at T2, FM had reached 43% (± 45%) of maximum recovery, while BBT had reached 25% (± 22%). Combining the effects of treatment to those of lesion side revealed significantly higher gains, in both FM and BBT scores, in left hemiparetic subjects when exposed to AO as compared to standard rehabilitation alone (P < .01). The findings lead to recommend the use of AO in addition to motor training in left hemiparetic patients.
动作观察（AO）对亚急性中风患者上肢功能恢复的临床影响是最近的研究证据。我们试图验证这样一个假设：通过动作观察结合任务执行来训练日常生活活动，可能会使左半球与右半球的激活情况有所不同。67名首次发生缺血性中风的受试者被随机分配接受上肢训练并结合动作观察任务或标准康复治疗。两组在年龄、性别、巴姆福德分类、中风间隔时间和病变侧等方面进行了匹配。采用Fugl-Meyer（FM）和箱块测试（BBT）来测量治疗结束时（T1）以及治疗后4至5个月（T2）的手部功能恢复情况。在T1时，FM增加了最大可实现恢复量的31%（±26%），而BBT增加了17%（±18%）；在T2时，FM达到了最大恢复量的43%（±45%），而BBT达到了25%（±22%）。将治疗效果与病变侧的影响相结合发现，与单独的标准康复治疗相比，左半身偏瘫受试者在接受动作观察治疗时，FM和BBT评分的提高都显著更高（P < .01）。研究结果表明，除了对左半身偏瘫患者进行运动训练外，还应推荐使用动作观察疗法。
