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改良强制性运动疗法联合躯干约束对慢性脑卒中的影响:一项双盲随机对照试验。

Effects of modified constraint-induced movement therapy combined with trunk restraint in chronic stroke: A double-blinded randomized controlled pilot trial.

作者信息

Bang Dae-Hyouk, Shin Won-Seob, Choi Ho-Suk

机构信息

Department of Physical Therapy, Graduate School of Daejeon University, Daejeon, Republic of Korea.

Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Daejeon, Republic of Korea.

出版信息

NeuroRehabilitation. 2015;37(1):131-7. doi: 10.3233/NRE-151245.

Abstract

BACKGROUND

Reducing the compensatory mechanism by restraining the unnecessary movement may be helpful in relearning the upper-limb movement.

OBJECTIVE

To investigate the effects of a modified constraint-induced movement therapy (mCIMT) with trunk restraint (TR) in chronic stroke patients with moderate impairment.

METHODS

Eighteen participants with hemiparesis were randomly assigned to mCIMT + TR or mCIMT. Each group underwent 20 (1 h/d) intervention session (5 d/wk for 4 weeks). Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment upper extremity (FMA-UE), the modified Barthel index (MBI), and the motor activity log (MAL-AOU and MAL-QOM).

RESULTS

The mCIMT combined with trunk restraint group exhibited greater changes in the ARAT, FMA, MBI, and MAL (MAL-AOU and MAL-QOM) compared with the mCIMT group. Statistical analyses showed significantly different in ARAT (Z = -2.17, P = 0.03), FMA-UE (Z = -2.49, P = 0.01), MBI (Z = -2.44, P = 0.02), MAL-AOU (Z = -2.17, P = 0.03), and MAL-QOM (Z = -2.17, P = 0.03) between groups.

CONCLUSION

These finding suggest that mCIMT combined with trunk restraint is more helpful to improve upper-extremity function than mCIMT only in patient with chronic stroke.

摘要

背景

通过抑制不必要的运动来减少代偿机制可能有助于上肢运动再学习。

目的

探讨改良强制性运动疗法(mCIMT)联合躯干约束(TR)对中度功能障碍的慢性脑卒中患者的影响。

方法

18例偏瘫患者被随机分为mCIMT+TR组或mCIMT组。每组接受20次(每天1小时)干预疗程(每周5天,共4周)。采用动作研究臂测试(ARAT)、Fugl-Meyer上肢评定量表(FMA-UE)、改良Barthel指数(MBI)以及运动活动日志(MAL-AOU和MAL-QOM)对患者进行评估。

结果

与mCIMT组相比,mCIMT联合躯干约束组在ARAT、FMA、MBI以及MAL(MAL-AOU和MAL-QOM)方面表现出更大的变化。统计分析显示,两组在ARAT(Z=-2.17,P=0.03)、FMA-UE(Z=-2.49,P=0.01)、MBI(Z=-2.44,P=0.02)、MAL-AOU(Z=-2.17,P=0.03)和MAL-QOM(Z=-2.17,P=0.03)上存在显著差异。

结论

这些结果表明,对于慢性脑卒中患者,mCIMT联合躯干约束比单纯mCIMT更有助于改善上肢功能。

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