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手指感知训练对急性脑卒中患者偏瘫上肢功能恢复的影响

Effects of Training for Finger Perception on Functional Recovery of Hemiplegic Upper Limbs in Acute Stroke Patients.

作者信息

Umeki Naho, Murata Jun, Higashijima Misako

机构信息

Department of Physical and Occupational Therapy, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan.

出版信息

Occup Ther Int. 2019 Nov 4;2019:6508261. doi: 10.1155/2019/6508261. eCollection 2019.

Abstract

BACKGROUND

Stroke causes severe disability, including motor and sensory impairments. We hypothesized that upper limb functional recovery after stroke may be augmented by combining treatments for motor and sensory functions. In order to examine this hypothesis, we conducted a controlled trial on rehabilitation for sensory function to the plegic hand.

METHODS

The sensory training program consisted of several types of discrimination tasks performed under blind conditions. The sensory training program was performed for 20 min per day, 5 days a week. An experimental group of 31 patients followed this sensory program, while a control group of 25 patients underwent standard rehabilitation. The efficacy of the intervention was evaluated by the tactile-pressure threshold, handgrip strength, and the completion time of manipulating objects. A two-way repeated measures analysis of variance was used to assess interactions between group and time. Moreover, to provide a meaningful analysis for comparisons, effect sizes were calculated using Cohen's .

RESULTS

The mean change in the tactile pressure threshold was significantly larger in the experimental group than in the control group ( < 0.05, = 0.59). Moreover, the completion times to manipulate a middle-sized ball ( = 0.53) and small ball ( = 0.80) and a small metal disc ( = 0.81) in the experimental group were significantly different from those in the control group ( < 0.05).

CONCLUSION

The present results suggest that the sensory training program to enhance finger discrimination ability contributes to improvements in not only sensory function but also manual function in stroke patients. The trial is registered with the UMIN Clinical Trials Registry (UMIN000032025).

摘要

背景

中风会导致严重残疾,包括运动和感觉障碍。我们假设,通过结合运动和感觉功能的治疗方法,可能会增强中风后上肢功能的恢复。为了验证这一假设,我们针对瘫痪手的感觉功能康复进行了一项对照试验。

方法

感觉训练计划包括在盲视条件下进行的几种辨别任务。感觉训练计划每天进行20分钟,每周进行5天。31名患者的实验组遵循此感觉训练计划,而25名患者的对照组接受标准康复治疗。通过触觉压力阈值、握力和操作物体的完成时间来评估干预效果。采用双向重复测量方差分析来评估组间和时间的交互作用。此外,为了进行有意义的比较分析,使用科恩d值计算效应量。

结果

实验组触觉压力阈值的平均变化显著大于对照组(<0.05,d = 0.59)。此外,实验组操作中等大小球(d = 0.53)、小球(d = 0.80)和小金属盘(d = 0.81)的完成时间与对照组有显著差异(<0.05)。

结论

目前的结果表明,增强手指辨别能力的感觉训练计划不仅有助于改善中风患者的感觉功能,还能改善其手部功能。该试验已在日本大学医学情报网临床试验注册中心注册(UMIN000032025)。

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