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便携式肌电支具的使用可促进慢性中风后偏瘫患者上肢功能恢复及参与度,但不影响其运动学表现。

Portable Myoelectric Brace Use Increases Upper Extremity Recovery and Participation But Does Not Impact Kinematics in Chronic, Poststroke Hemiparesis.

作者信息

Willigenburg Nienke W, McNally Michael P, Hewett Timothy E, Page Stephen J

机构信息

a Sports Health and Performance Institute, OSU Sports Medicine , The Ohio State University , Columbus , Ohio.

b Joint Research, Department of Orthopaedic Surgery , OLVG , Amsterdam , the Netherlands.

出版信息

J Mot Behav. 2017 Jan-Feb;49(1):46-54. doi: 10.1080/00222895.2016.1152220. Epub 2016 Oct 17.

DOI:10.1080/00222895.2016.1152220
PMID:27749154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5470353/
Abstract

The authors examined the efficacy of an 8-week regimen combining repetitive task-specific practice (RTP) with a myoelectric brace (RTP+Myomo) on paretic upper extremity (UE; use in valued activities, perceived recovery, and reaching kinematics) in 12 subjects (4 men; M age = 53.5 years; mean time poststroke = 61.7 months). Seven subjects were administered RTP+Myomo therapy, and 5 were administered RTP only. Both groups participated in individualized, 45-min therapy sessions occurring 3 days/week over an 8-week period. The arm, hand ability, activities of daily living, and perceptions of recovery subscales of the Stroke Impact Scale (SIS), as well as UE reaching kinematics, assessed before and after the intervention. Subjects in the RTP+Myomo group showed greater improvements on all SIS subscales, with the recovery scale reaching statistical significance (p = .03). Subjects in the RTP-only group showed a greater increase in hand velocity in the reach up task (p = .02), but no changes were observed in the range of shoulder flexion or elbow extension during reaching. None of the changes in kinematic outcome measures significantly correlated with any of the changes in SIS subscales. RTP integrating myoelectric bracing may be more beneficial than RTP only in improving self-reported function and perceptions of overall recovery. The authors observed no changes in the range of elbow extension, and no relationship between self-reported improvements and changes in reaching kinematics.

摘要

作者对12名受试者(4名男性;平均年龄=53.5岁;卒中后平均时间=61.7个月)进行了一项为期8周的治疗方案,该方案将重复性特定任务练习(RTP)与肌电支具(RTP+Myomo)相结合,用于治疗患侧上肢(UE;在有价值活动中的使用、感知恢复和伸手运动学)。7名受试者接受了RTP+Myomo治疗,5名受试者仅接受了RTP治疗。两组均参加了为期8周、每周3天、每次45分钟的个体化治疗课程。在干预前后评估了卒中影响量表(SIS)的手臂、手部能力、日常生活活动和恢复感知分量表,以及UE伸手运动学。RTP+Myomo组的受试者在所有SIS分量表上均有更大改善,恢复分量表达到统计学显著性(p = 0.03)。仅接受RTP治疗的组受试者在向上伸手任务中的手部速度有更大增加(p = 0.02),但在伸手过程中未观察到肩屈曲或肘伸展范围的变化。运动学结果测量的任何变化均与SIS分量表的任何变化无显著相关性。在改善自我报告的功能和总体恢复感知方面,整合肌电支具的RTP可能比仅RTP更有益。作者未观察到肘伸展范围的变化,且自我报告的改善与伸手运动学变化之间无关联。

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本文引用的文献

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Understanding adaptive motor control of the paretic upper limb early poststroke: the EXPLICIT-stroke program.理解卒中后早期瘫痪上肢的自适应运动控制:EXPLICIT-stroke 项目。
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