From the Clinical Health & Nutrition Centre (CHANCE), Department of Life Sciences, Institute of Technology, Sligo, Ireland (ME, DS, PB, KM); Physiotherapy & Population Science, University College Dublin, Dublin, Ireland (CB); Faculty of Medicine & Health Sciences, Royal College of Surgeons Ireland, Dublin, Ireland (FH); and University Hospital, Sligo, Ireland (PH, JO).
Am J Phys Med Rehabil. 2019 Aug;98(8):657-665. doi: 10.1097/PHM.0000000000001162.
The aim of the study was to investigate the feasibility and potential effectiveness of mirror-aided cross-education compared with cross-education alone in poststroke upper limb recovery.
A pilot randomized controlled parallel group study was carried out. Thirty-two patients with chronic stroke followed a 4-wk isometric strength training program performed with the less-affected upper limb three times per week. Participants in the mirror and strength training group observed the reflection of the exercising arm in the mirror. Participants in the strength training only group exercised without a mirror entirely. Participant compliance, adverse effects, and suitability of outcome measures assessed feasibility. Effectiveness outcomes included maximal isometric strength measured with the Biodex Dynamometer, the Modified Ashworth Scale, and the Chedoke Arm and Hand Activity Inventory.
Compliance was high with no adverse effects. The use of the Biodex Dynamometer must be reviewed. Mirror therapy did not augment the cross-education effect (P > 0.05) in patients with chronic stroke when training isometrically.
This pilot trial established the feasibility of a randomized controlled trial comparing mirror-aided cross-education with cross-education alone for poststroke upper limb recovery. Mirror therapy did not augment cross-education when training isometrically. However, results indicate that the combination of interventions should be investigated further applying an altered training protocol.
本研究旨在探讨镜像辅助交叉训练相较于单纯交叉训练对脑卒中后上肢恢复的可行性和潜在效果。
一项先导随机对照平行组研究。32 例慢性脑卒中患者遵循每周 3 次、每次使用非瘫痪侧上肢进行 4 周等长力量训练方案。镜像和力量训练组的参与者观察到自身锻炼手臂在镜子中的反射。仅进行力量训练组的参与者完全不使用镜子进行训练。参与者依从性、不良反应和测量结果的适宜性评估了可行性。有效性结果包括使用 Biodex 动态测力仪测量的最大等长力量、改良 Ashworth 量表和 Chedoke 上肢和手活动量度表。
无不良反应，高依从性。必须对 Biodex 动态测力仪的使用进行审查。当进行等长训练时，镜像疗法并没有增强慢性脑卒中患者的交叉训练效果（P>0.05）。
本先导试验确立了一项随机对照试验的可行性，该试验比较了镜像辅助交叉训练与单纯交叉训练对脑卒中后上肢恢复的效果。当进行等长训练时，镜像疗法并未增强交叉训练效果。然而，结果表明应进一步研究联合干预措施，并采用改变后的训练方案。
