Hatem Samar M, Saussez Geoffroy, Della Faille Margaux, Prist Vincent, Zhang Xue, Dispa Delphine, Bleyenheuft Yannick
Physical and Rehabilitation Medicine, Brugmann University HospitalBrussels, Belgium; Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de LouvainBrussels, Belgium; Faculty of Medicine and Pharmacy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit BrusselBrussels, Belgium.
Systems and Cognitive Neuroscience, Institute of Neuroscience, Université Catholique de Louvain Brussels, Belgium.
Front Hum Neurosci. 2016 Sep 13;10:442. doi: 10.3389/fnhum.2016.00442. eCollection 2016.
Stroke is one of the leading causes for disability worldwide. Motor function deficits due to stroke affect the patients' mobility, their limitation in daily life activities, their participation in society and their odds of returning to professional activities. All of these factors contribute to a low overall quality of life. Rehabilitation training is the most effective way to reduce motor impairments in stroke patients. This multiple systematic review focuses both on standard treatment methods and on innovating rehabilitation techniques used to promote upper extremity motor function in stroke patients. A total number of 5712 publications on stroke rehabilitation was systematically reviewed for relevance and quality with regards to upper extremity motor outcome. This procedure yielded 270 publications corresponding to the inclusion criteria of the systematic review. Recent technology-based interventions in stroke rehabilitation including non-invasive brain stimulation, robot-assisted training, and virtual reality immersion are addressed. Finally, a decisional tree based on evidence from the literature and characteristics of stroke patients is proposed. At present, the stroke rehabilitation field faces the challenge to tailor evidence-based treatment strategies to the needs of the individual stroke patient. Interventions can be combined in order to achieve the maximal motor function recovery for each patient. Though the efficacy of some interventions may be under debate, motor skill learning, and some new technological approaches give promising outcome prognosis in stroke motor rehabilitation.
中风是全球导致残疾的主要原因之一。中风导致的运动功能缺陷会影响患者的行动能力、日常生活活动受限程度、社会参与度以及恢复职业活动的几率。所有这些因素都会导致总体生活质量低下。康复训练是减轻中风患者运动障碍的最有效方法。这项多项系统评价既关注标准治疗方法，也关注用于促进中风患者上肢运动功能的创新康复技术。对总共5712篇关于中风康复的出版物进行了系统评价，以确定其与上肢运动结果的相关性和质量。这一过程产生了270篇符合系统评价纳入标准的出版物。文中讨论了近期基于技术的中风康复干预措施，包括非侵入性脑刺激、机器人辅助训练和虚拟现实沉浸式训练。最后，基于文献证据和中风患者特征提出了一个决策树。目前，中风康复领域面临着根据个体中风患者的需求制定循证治疗策略的挑战。可以将干预措施结合起来，以便为每个患者实现最大程度的运动功能恢复。尽管一些干预措施的疗效可能存在争议，但运动技能学习和一些新技术方法在中风运动康复中给出了有希望的预后结果。
