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慢性卒中患者的镜像疗法与跑步机训练:一项初步随机对照试验

Mirror therapy and treadmill training for patients with chronic stroke: a pilot randomized controlled trial.

作者信息

Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K

机构信息

a School of Science , Institute of Technology Sligo , Sligo , Ireland.

b School of Physiotherapy , Royal College of Surgeons in Ireland , Dublin , Ireland.

出版信息

Top Stroke Rehabil. 2019 Apr;26(3):163-172. doi: 10.1080/10749357.2018.1556504. Epub 2018 Dec 22.

DOI:10.1080/10749357.2018.1556504
PMID:30580672
Abstract

BACKGROUND

Previous lower-limb mirror therapy research has focused on non-weight bearing interventions.

OBJECTIVES

The primary aim of this study was to investigate the effect and feasibility of a combination of mirror therapy and treadmill training on post-stroke lower-limb recovery compared to a placebo intervention.

METHODS

All patients (N = 30) walked on a treadmill for 30 min per day, 3 days per week, for 4 weeks. The mirror therapy and treadmill training group (n = 15) walked on the treadmill while viewing a reflection of their non-paretic limb in a mirror positioned in their mid-sagittal plane. The placebo group (n = 15) received no mirror visual feedback due to an altered mirror position.

PRIMARY OUTCOME MEASURES

Ten Metre Walk Test (10MWT) and Six Minute Walk Test (6MWT).

SECONDARY OUTCOME MEASURES

Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment-Lower Extremity (FMA-LE). Feasibility was appraised by examining participant compliance and any adverse events.

RESULTS

No significant between group differences were demonstrated for the 10MWT, 6MWT or FMA-LE at post-training or 3-month follow-up assessment. A significant between group difference on the MAS was demonstrated in the reduction of ankle dorsiflexion muscle tone (p = 0.006) and ankle plantarflexion muscle tone (p = 0.01) in the mirror therapy group compared to the placebo group at post-training assessment but not at 3-month follow-up.

CONCLUSION

Our study reveals that in our group of patients with chronic stroke, mirror therapy combined with treadmill training facilitated significant reductions in ankle muscle tone (p < 0.05) compared to a placebo intervention.

摘要

背景

以往的下肢镜像疗法研究主要集中在非负重干预上。

目的

本研究的主要目的是探讨与安慰剂干预相比,镜像疗法与跑步机训练相结合对中风后下肢恢复的效果和可行性。

方法

所有患者(N = 30)每天在跑步机上行走30分钟,每周3天,共4周。镜像疗法和跑步机训练组(n = 15)在跑步机上行走时,通过位于矢状面中部的镜子观察其非患侧肢体的反射影像。安慰剂组(n = 15)因镜子位置改变未接受镜像视觉反馈。

主要结局指标

十米步行试验(10MWT)和六分钟步行试验(6MWT)。

次要结局指标

改良Ashworth量表(MAS)和Fugl-Meyer下肢评定量表(FMA-LE)。通过检查参与者的依从性和任何不良事件来评估可行性。

结果

在训练后或3个月随访评估时,10MWT、6MWT或FMA-LE在组间未显示出显著差异。与安慰剂组相比,在训练后评估时,镜像疗法组在降低踝背屈肌张力(p = 0.006)和踝跖屈肌张力(p = 0.01)方面在MAS上显示出显著的组间差异,但在3个月随访时未显示。

结论

我们的研究表明,在我们的慢性中风患者组中,与安慰剂干预相比,镜像疗法与跑步机训练相结合能显著降低踝肌张力(p < 0.05)。

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