Bang Dae-Hyouk, Shin Won-Seob, Choi Ho-Suk
Department of Physical Therapy, Oriental Hospital, Wonkwang University, Ik-San, Republic of Korea.
Department of Physical Therapy, College of Health and Medical Science, Daejeon University, Daejeon, Republic of Korea.
NeuroRehabilitation. 2018;42(1):29-35. doi: 10.3233/NRE-172176.
Reducing compensatory strategies during repetitive upper-limb training may be helpful in relearning motor skills.
To explore the effects of modified constraint-induced movement therapy (mCIMT), additionally modified by adding trunk restraint (TR), on upper-limb function and activities of daily living (ADLs) in early post-stroke patients.
Twenty-four participants with early stroke were randomly assigned to mCIMT combined with TR (mCIMT + TR) or mCIMT alone. Each group underwent twenty sessions (1 h/d, 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), the Maximal elbow extension angle during reaching (MEEAR), and Motor Activity Logs (MAL-AOU and MAL-QOM).
The mCIMT + TR group exhibited greater improvement in the ARAT, FMA-UE, MBI, MEEAR, and MAL-AOU, and MAL-QOM than the mCIMT group. Statistical analyses showed significant differences in ARAT (P = 0.003), FMA-UE (P = 0.042), MBI (P = 0.001), MEEAR (P = 0.002), and MAL-AOU (P = 0.005) between the groups.
Modified CIMT combined with TR may be more effective than mCIMT alone in improving upper-limb function and ADLs in patients with early stroke.
在重复性上肢训练中减少代偿策略可能有助于重新学习运动技能。
探讨改良的强制性运动疗法（mCIMT），通过增加躯干约束（TR）进行额外改良，对早期卒中患者上肢功能和日常生活活动（ADL）的影响。
将24例早期卒中患者随机分为mCIMT联合TR组（mCIMT+TR）或单纯mCIMT组。每组进行20次治疗（每天1小时，每周5天，共4周）。采用动作研究上肢测试（ARAT）、Fugl-Meyer上肢评估（FMA-UE）、改良Barthel指数（MBI）、伸手时最大肘关节伸展角度（MEEAR）以及运动活动日志（MAL-AOU和MAL-QOM）对患者进行评估。
与mCIMT组相比，mCIMT+TR组在ARAT、FMA-UE、MBI、MEEAR以及MAL-AOU和MAL-QOM方面有更大改善。统计分析显示，两组在ARAT（P=0.003）、FMA-UE（P=0.042）、MBI（P=0.001）、MEEAR（P=0.002）和MAL-AOU（P=0.005）方面存在显著差异。
改良的强制性运动疗法联合TR在改善早期卒中患者上肢功能和ADL方面可能比单纯mCIMT更有效。
