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任务导向训练对亚急性脑卒中患者上肢功能表现的影响:一项随机对照试验。

Effects of task-oriented training on upper extremity functional performance in patients with sub-acute stroke: a randomized controlled trial.

作者信息

Thant Aye Aye, Wanpen Sawitri, Nualnetr Nomjit, Puntumetakul Rungthip, Chatchawan Uraiwan, Hla Khin Myo, Khin Myo Thuzar

机构信息

School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University: 123 Mittraphap Rd., Mueang District, Khon Kaen, 40002, Thailand.

Department of Physiotherapy, University of Medical Technology-Yangon, Myanmar.

出版信息

J Phys Ther Sci. 2019 Jan;31(1):82-87. doi: 10.1589/jpts.31.82. Epub 2019 Jan 29.

Abstract

[Purpose] The present study aimed to determine the effects of a task-oriented training on paretic upper extremity functional performance in patients with subacute stroke. [Participants and Methods] Twenty-eight subacute stroke sufferers (mean age: 50.07, standard deviation 9.31 years; mean time since stroke 11.11, standard deviation 6.73 weeks) were randomly allocated to task-oriented training (n=14) or conventional exercise program (n=14) group. They were trained as a hospital-based, individualized training 1 hour a session, 5 sessions a week for 4 weeks. Wolf Motor Function Test (primary outcome), motor portion of Fugl-Meyer assessment upper extremity, and hand function domain of Stroke Impact Scale were assessed at baseline, after 2 and 4 weeks of training. [Results] All participants completed their training programs. At all post-training assessments, the task-oriented training group showed significantly more improvements in all outcomes than the conventional exercise program group. No serious adverse effects were observed during or after the training. [Conclusion] Task-oriented training produced statistically significant and clinically meaningful improvements of paretic upper extremity functional performance in patients with subacute stroke. These beneficial effects were observed after 2 weeks (10 hours) of training. Future investigation is warranted to confirm and expand these findings.

摘要

[目的] 本研究旨在确定任务导向训练对亚急性脑卒中患者患侧上肢功能表现的影响。[参与者与方法] 28例亚急性脑卒中患者(平均年龄:50.07岁,标准差9.31岁;卒中后平均时间11.11周,标准差6.73周)被随机分配至任务导向训练组(n = 14)或传统运动训练组(n = 14)。他们接受以医院为基础的个体化训练,每次训练1小时,每周5次,共4周。在基线、训练2周和4周后,评估Wolf运动功能测试(主要结局指标)、Fugl-Meyer上肢运动部分评估以及卒中影响量表的手部功能领域。[结果] 所有参与者均完成了训练计划。在所有训练后评估中,任务导向训练组在所有结局指标上的改善均显著多于传统运动训练组。训练期间及训练后均未观察到严重不良反应。[结论] 任务导向训练在亚急性脑卒中患者患侧上肢功能表现方面产生了具有统计学意义和临床意义的改善。这些有益效果在训练2周(10小时)后即可观察到。有必要进行进一步研究以证实并扩展这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ef1/6348189/8ef36a7ee6a0/jpts-31-082-g001.jpg

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