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中风感觉运动训练中的镜像错觉:一项随机对照试验。

Mirror Illusion for Sensori-Motor Training in Stroke: A Randomized Controlled Trial.

作者信息

Arya Kamal Narayan, Pandian Shanta, Puri Vinod

机构信息

Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India.

Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India.

出版信息

J Stroke Cerebrovasc Dis. 2018 Nov;27(11):3236-3246. doi: 10.1016/j.jstrokecerebrovasdis.2018.07.012. Epub 2018 Aug 16.

DOI:10.1016/j.jstrokecerebrovasdis.2018.07.012
PMID:30120033
Abstract

BACKGROUND

Poststroke, sensory deficits are not uncommon. In spite of the close association between the sensory and motor recovery, the deficits are usually underemphasized. Mirror therapy (MT), a neural-based approach for the motor deficit has not been explored for the sensory impairment. The objective of the present study was to develop and determine the effect of a MT program for sensori-motor impairment among poststroke subjects.

METHODS DESIGN

Randomized controlled trial.

SETTING

Functional therapy laboratory of Rehabilitation Institute.

PARTICIPANTS

Thirty-one chronic poststroke subjects (17 experimental and 14 controls), aged between 30 and 60years, with ≤ diminished light touch in the hand.

OUTCOME MEASURE

Semmes Weinstein Monofilament (cutaneous threshold), 2-Point discrimination test (touch discrimination) and Fugl-Meyer Assessment (hand motor recovery).

INTERVENTION

The experimental group received sensory stimulus such as tactile perception and motor tasks on the less-affected hand using mirror box. The control counterparts underwent only dose-matched conventional program. 30 sessions with a frequency of 5/week were imparted to the groups.

RESULTS

Post intervention, there was a significant (P < .004) increase up to 30% positive touch-response for the hand quadrants among the experimental group in comparison to only 13.5% rise for the same among the controls. The cutaneous threshold of the less-affected palm also improved significantly among the experimental subjects in comparison to the controls (P = .04).

CONCLUSION

MT may be considered as a promising regime for enhancing cutaneous sensibility in stroke. The mirror illusion induced by MT may be utilized for sensory and motor deficits as well as for the more-affected and less-affected hands.

摘要

背景

中风后,感觉障碍并不罕见。尽管感觉和运动恢复之间存在密切关联,但这些障碍通常未得到足够重视。镜像疗法(MT)是一种针对运动障碍的基于神经学的方法,尚未用于探索感觉障碍。本研究的目的是开发并确定针对中风后患者感觉运动障碍的镜像疗法方案的效果。

方法设计

随机对照试验。

地点

康复研究所功能治疗实验室。

参与者

31名中风后慢性患者(17名实验组和14名对照组),年龄在30至60岁之间,手部轻触觉减退≤。

结局指标

Semmes Weinstein单丝试验(皮肤阈值)、两点辨别试验(触觉辨别)和Fugl-Meyer评估(手部运动恢复)。

干预措施

实验组使用镜像箱在受影响较小的手上接受感觉刺激,如触觉感知和运动任务。对照组仅接受剂量匹配的传统方案。两组均接受30次治疗,每周5次。

结果

干预后,实验组手部象限的阳性触觉反应显著增加(P <.004),高达30%,而对照组仅增加13.5%。与对照组相比,实验组受影响较小的手掌的皮肤阈值也有显著改善(P =.04)。

结论

镜像疗法可被视为一种有前景的改善中风患者皮肤感觉的方法。镜像疗法诱导的镜像错觉可用于感觉和运动障碍,以及受影响较大和较小的手部。

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