Kim Hee, Yoo Eun-Young, Jung Min-Ye, Kim Jongbae, Park Ji-Hyuk, Kang Dae-Hyuk
a Department of Occupational Therapy , Konyang University , Daejeon , Republic of Korea.
b Department of Occupational Therapy , Yonsei University , Wonju , Republic of Korea.
Disabil Rehabil. 2018 Oct;40(20):2449-2457. doi: 10.1080/09638288.2017.1337817. Epub 2017 Jun 9.
Studies on to what extent the combined therapy of modified constraint-induced movement therapy and mental practice is more effective than modified constraint-induced movement therapy alone are lacking. This study aims to compare the effects of the combined therapy with modified constraint-induced movement therapy alone on corticospinal excitability, quality of the movement of the affected upper extremity, upper motor functions, and performance of the affected arm in daily life of hemiplegic stroke patients.
The participants comprised 14 people who had suffered stroke and were randomly divided into two groups. All participants participated in modified constraint-induced movement therapy, while only the experimental group partook in additional mental practice. Both groups were tested for corticospinal excitability, quality of movement, hand function, and activities of daily living.
Both groups showed significant improvement in the movement quality of reaching and performance of activities of daily living. In the experimental group, functional improvement of the upper limb was also observed. The improvements in corticospinal excitability, upper extremity function, and performance in daily activities were significantly greater in the experimental group compared to the control group.
This study confirmed that the combined therapy produces more effective improvement in corticospinal excitability, upper limb function, and performance in daily activities. The combined therapy of mental practice and modified constraint-induced movement therapy could be used as a clinically useful intervention. Implications for rehabilitation Modified constraint-induced movement therapy could be used as an intervention method for people with stroke to make improvements in the quality of movement and performance in activities of daily livings with the affected side. With additional mental practice, upper extremity functions improve, and changes in neurological, functional and performance in daily lives are greater compared to modified constraint-induced movement therapy without mental practice. Impact of mental practice has on rehabilitation should not be underestimated.
目前缺乏关于改良的强制性使用运动疗法与心理练习相结合的疗法在何种程度上比单纯的改良强制性使用运动疗法更有效的研究。本研究旨在比较联合疗法与单纯改良强制性使用运动疗法对偏瘫中风患者皮质脊髓兴奋性、患侧上肢运动质量、上运动功能以及患侧手臂在日常生活中的表现的影响。
参与者包括14名中风患者，他们被随机分为两组。所有参与者都接受改良的强制性使用运动疗法，而只有实验组额外进行心理练习。两组都接受了皮质脊髓兴奋性、运动质量、手部功能和日常生活活动的测试。
两组在伸手动作质量和日常生活活动表现方面均有显著改善。在实验组中，还观察到上肢功能的改善。与对照组相比，实验组在皮质脊髓兴奋性、上肢功能和日常活动表现方面的改善明显更大。
本研究证实联合疗法在皮质脊髓兴奋性、上肢功能和日常活动表现方面产生了更有效的改善。心理练习与改良的强制性使用运动疗法相结合可作为一种临床上有用的干预措施。康复意义 改良的强制性使用运动疗法可作为中风患者的一种干预方法，以改善患侧的运动质量和日常生活活动表现。通过额外的心理练习，上肢功能得到改善，与没有心理练习的改良强制性使用运动疗法相比，神经、功能和日常生活表现的变化更大。不应低估心理练习对康复的影响。
