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附加躯干约束的家庭改良强制性运动疗法对上肢轻中度运动障碍的慢性脑卒中患者并无额外获益:一项前瞻性随机对照试验。

Addition of trunk restraint to home-based modified constraint-induced movement therapy does not bring additional benefits in chronic stroke individuals with mild and moderate upper limb impairments: A pilot randomized controlled trial.

机构信息

Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Department of Physical Therapy, Centro Universitário Newton Paiva, Belo Horizonte, Brazil.

Department of Physical Therapy, Universidade do Estado de Santa Catarina, Florianópolis, Brazil.

出版信息

NeuroRehabilitation. 2014;35(3):391-404. doi: 10.3233/NRE-141130.

Abstract

BACKGROUND

People with stroke excessively move their trunk, when reaching and grasping objects.

OBJECTIVE

To determine if the addition of trunk restraint to modified constraint-induced movement therapy (mCIMT) was better than mCIMT alone in improving strength, function, and quality of life after stroke.

METHODS

A pilot randomized double-blinded clinical trial was conducted. Twenty-two participants with chronic stroke were randomly assigned to an experimental group that received mCIMT plus trunk restraint, or a control group (only mCIMT). Primary outcomes were the amount of use and quality of movement of the paretic upper limb (UL), determined by the Motor Activity Log (MAL) scores. Secondary outcomes included the observed performance of the paretic UL during unimanual and bimanual tasks, kinematics of reaching, strength, and quality of life.

RESULTS

Both groups demonstrated significant improvements in the MAL scores and in the time to perform bimanual activities immediately after the interventions. However, no between-group differences were observed.

CONCLUSIONS

The addition of trunk restraint to mCIMT resulted in no additional benefits, compared with mCIMT alone with stroke individuals with mild to moderate impairments. Unimanual and bimanual improvements were observed after mCIMT, regardless of trunk restraint, and the intervention did not adversely affect their reaching patterns.

摘要

背景

患有中风的人在伸手和抓握物体时过度移动躯干。

目的

确定在改良强制性运动疗法(mCIMT)中增加躯干约束是否优于单独使用 mCIMT,以改善中风后的力量、功能和生活质量。

方法

进行了一项试点随机双盲临床试验。22 名患有慢性中风的参与者被随机分配到实验组,接受 mCIMT 加躯干约束,或对照组(仅接受 mCIMT)。主要结局是使用量和瘫痪上肢(UL)运动质量的变化,通过运动活动日志(MAL)评分来确定。次要结局包括在单手和双手任务中观察到的瘫痪上肢的表现、伸手运动学、力量和生活质量。

结果

两组在 MAL 评分和干预后立即进行双手活动的时间方面都有显著改善。然而,组间没有差异。

结论

与单独使用 mCIMT 相比,在 mCIMT 中增加躯干约束对轻度至中度障碍的中风个体没有额外的益处。mCIMT 后观察到单手和双手的改善,无论是否使用躯干约束,并且干预并没有对他们的伸手模式产生不利影响。

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