儿童重复经颅磁刺激和强制性运动疗法临床试验后实体觉的稳定性
Stability of stereognosis after pediatric repetitive transcranial magnetic stimulation and constraint-induced movement therapy clinical trial.
作者信息
Rich Tonya, Cassidy Jessica, Menk Jeremiah, Van Heest Ann, Krach Linda, Carey James, Gillick Bernadette T
机构信息
a Department of Physical Medicine and Rehabilitation Medical School , University of Minnesota , Minneapolis , MN , USA.
b Biostatistician Clinical and Translational Science Institute , Minneapolis , MN , USA.
出版信息
Dev Neurorehabil. 2017 Apr;20(3):169-172. doi: 10.3109/17518423.2016.1139008. Epub 2016 Mar 17.
OBJECTIVE
Poor sensibility affecting stereognosis, the ability to discriminate objects without visual input, can potentiate disuse of the paretic limb following stroke. The purpose of this study was to examine potential change in stereognosis after intervention.
METHODS
Stereognosis testing in a secondary subgroup of 10 children with hemiparesis and baseline stereognosis deficits (ages 11-16) after a 13-day clinical trial of real or sham repetitive transcranial magnetic stimulation (rTMS) and constraint-induced movement therapy (CIMT) is reported. All children received 10 h of CIMT while wearing a cast full-time.
RESULTS
Post-trial, 80% of participants from both intervention groups demonstrated improvement in stereognosis (95% CI: 44.4%-97.5%). Pre-trial to long-term follow-up (range: 21-57 months), 60% retained gains or improved (95% CI: 26.2%-87.8%). Between-group differences were not detected.
DISCUSSION
Children demonstrated stereognosis change following intervention. Research on this change and potential minimal clinically important differences are indicated.
目的
感觉功能不佳会影响实体觉（即在无视觉输入的情况下辨别物体的能力），进而可能加重中风后瘫痪肢体的废用。本研究的目的是检查干预后实体觉的潜在变化。
方法
报告了在10名患有偏瘫且基线实体觉存在缺陷的儿童（年龄11 - 16岁）的二级亚组中进行的实体觉测试，这些儿童接受了为期13天的真实或假重复经颅磁刺激（rTMS）和强制性运动疗法（CIMT）临床试验。所有儿童在全天佩戴支具的同时接受10小时的CIMT。
结果
试验后，两个干预组中80%的参与者实体觉有改善（95%置信区间：44.4% - 97.5%）。从试验前到长期随访（范围：21 - 57个月），60%的参与者保持了改善或进一步改善（95%置信区间：26.2% - 87.8%）。未检测到组间差异。
讨论
儿童在干预后实体觉出现变化。需要对这种变化以及潜在的最小临床重要差异进行研究。
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