Bai Zhongfei, Zhang Jiaqi, Zhang Ziwei, Shu Tian, Niu Wenxin
Department of Occupational Therapy, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China.
Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, China.
Front Neurol. 2019 Mar 26;10:288. doi: 10.3389/fneur.2019.00288. eCollection 2019.
The aim of this trial was to compare the effect of movement-based mirror therapy (MMT) and task-based mirror therapy (TMT) on improving upper limb functions in patients with stroke. A total of 34 patients with sub-acute stroke with mildly to moderately impaired upper limb motor functions. The participants were randomly allocated to one of three groups: MMT, TMT, and conventional treatment (CT). The MMT group underwent movement-based mirror therapy for around 30 min/day, 5 days/week, for 4 weeks, whereas the TMT group underwent dose-matched TMT. The CT group underwent only conventional rehabilitation. The MMT and TMT groups underwent CT in addition to their mirror therapy. Blinded assessments were administered at baseline and immediately after the intervention. Upper limb motor functions, measured using Fugl-Meyer Assessment-upper extremity (FMA-UE), Wolf Motor Function Test (WMFT), and hand grip strength; upper limb spasticity, measured using the modified Ashworth scale (MAS); and activities of daily living, measured using the modified Barthel index (MBI). A significant time-by-group interaction effect was noted in FMA-UE. analysis of change scores showed that MMT yielded a better effect on improving FMA-UE than the other two therapies, at a marginally significant level ( = 0.050 and 0.022, respectively). No significant interaction effect was noted in WMFT, hand grip strength, MAS, and MBI. Both MMT and TMT are effective in improving the upper limb function of patients with mild to moderate hemiplegia due to stroke. Nevertheless, MMT seems to be superior to TMT in improving hemiplegic upper extremity impairment. Further studies with larger stroke cohorts are expected to be inspired by this pilot trial. No. ChiCTR1800019043 (http://www.chictr.org.cn/index.aspx).
本试验的目的是比较基于运动的镜像疗法（MMT）和基于任务的镜像疗法（TMT）对改善中风患者上肢功能的效果。共有34例亚急性中风患者，其上肢运动功能轻度至中度受损。参与者被随机分配到三组之一：MMT组、TMT组和传统治疗（CT）组。MMT组每天进行约30分钟的基于运动的镜像疗法，每周5天，共4周，而TMT组接受剂量匹配的TMT。CT组仅接受传统康复治疗。MMT组和TMT组在镜像疗法之外还接受CT治疗。在基线和干预后立即进行盲法评估。使用Fugl-Meyer评估上肢（FMA-UE）、Wolf运动功能测试（WMFT）和握力测量上肢运动功能；使用改良Ashworth量表（MAS）测量上肢痉挛；使用改良Barthel指数（MBI）测量日常生活活动能力。在FMA-UE中观察到显著的组间时间交互效应。变化分数分析表明，MMT在改善FMA-UE方面比其他两种疗法产生了更好的效果，达到边缘显著水平（分别为=0.050和0.022）。在WMFT、握力、MAS和MBI中未观察到显著的交互效应。MMT和TMT在改善中风所致轻度至中度偏瘫患者的上肢功能方面均有效。然而，在改善偏瘫上肢损伤方面，MMT似乎优于TMT。预计这项初步试验将激发对更大中风队列的进一步研究。注册号：ChiCTR1800019043（http://www.chictr.org.cn/index.aspx）
