TheraBracelet 刺激在任务练习疗法中改善中风后上肢功能：一项初步的随机对照研究。
TheraBracelet Stimulation During Task-Practice Therapy to Improve Upper Extremity Function After Stroke: A Pilot Randomized Controlled Study.
机构信息
Division of Occupation Therapy, Department of Health Professions, Department of Health Sciences and Research, Medical University of South Carolina, 151B Rutledge Ave, Charleston, SC 29425 (USA).
Department of Health Sciences and Research, Medical University of South Carolina.
出版信息
Phys Ther. 2019 Mar 1;99(3):319-328. doi: 10.1093/ptj/pzy143.
BACKGROUND
Peripheral sensory stimulation has been used in conjunction with upper extremity movement therapy to increase therapy-induced motor gains in patients with stroke. The limitation is that existing sensory stimulation methods typically interfere with natural hand tasks and thus are administered prior to therapy, requiring patients' time commitment. To address this limitation, we developed TheraBracelet. This novel stimulation method provides subthreshold (ie, imperceptible) vibratory stimulation to the wrist and can be used during hand tasks/therapy without interfering with natural hand tasks.
OBJECTIVE
The objective was to determine the feasibility of using TheraBracelet during therapy to augment motor recovery after stroke.
DESIGN
The design was a triple-blinded pilot randomized controlled trial.
METHODS
Twelve chronic stroke survivors were assigned to the treatment or control group. All participants completed 2-hour task practice therapy sessions thrice weekly for 2 weeks. Both groups wore a small vibrator on the paretic wrist, which was turned on to provide TheraBracelet stimulation for the treatment group and turned off for the control group to provide sham stimulation. Outcome measures (Box and Block Test [BBT] and Wolf Motor Function Test [WMFT]) were obtained at baseline, 6 days after therapy, and at follow-up 19 days after therapy.
RESULTS
The intervention was feasible with no adverse events. The treatment group significantly improved their BBT scores after therapy and at follow-up compared with baseline, whereas the control group did not. For WMFT, the group × time interaction was short of achieving significance. Large effect sizes were obtained (BBT d = 1.43, WMFT d = 0.87). No indication of desensitization to TheraBracelet stimulation was observed.
LIMITATIONS
The limitation was a small sample size.
CONCLUSIONS
TheraBracelet could be a promising therapy adjuvant for upper extremity recovery after stroke.
背景
外周感觉刺激已与上肢运动疗法结合使用，以增加中风患者的治疗诱导运动收益。限制是现有的感觉刺激方法通常会干扰自然手部任务，因此在治疗前进行，需要患者投入时间。为了解决这个限制，我们开发了 TheraBracelet。这种新的刺激方法为手腕提供亚阈值（即不可察觉）的振动刺激，可在手任务/治疗期间使用，而不会干扰自然手部任务。
目的
目的是确定在治疗期间使用 TheraBracelet 来增强中风后运动恢复的可行性。
设计
该设计是一项三盲试点随机对照试验。
方法
12 名慢性中风幸存者被分配到治疗组或对照组。所有参与者每周完成 3 次 2 小时的任务练习治疗。两组均在手的麻痹手腕上佩戴一个小振动器，为治疗组提供 TheraBracelet 刺激，为对照组提供假刺激。在基线、治疗后 6 天和治疗后 19 天获得 Box 和 Block 测试（BBT）和 Wolf 运动功能测试（WMFT）的结果。
结果
干预措施是可行的，没有不良事件。与基线相比，治疗组在治疗后和随访时的 BBT 评分显著提高，而对照组则没有。对于 WMFT，组间×时间交互作用没有达到显著水平。获得了较大的效应量（BBT d=1.43，WMFT d=0.87）。没有观察到对 TheraBracelet 刺激脱敏的迹象。
局限性
局限性是样本量小。
结论
TheraBracelet 可能是中风后上肢恢复的一种有前途的治疗辅助手段。
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