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躯干约束在任务导向训练中对改善脑卒中患者功能的影响:系统评价和荟萃分析。

The effect of adding trunk restraint to task-oriented training in improving function in stroke patients: A systematic review and meta-analysis.

机构信息

Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China.

出版信息

NeuroRehabilitation. 2020;46(1):95-108. doi: 10.3233/NRE-192964.

Abstract

BACKGROUND

The effectiveness of trunk restraint on post-stroke arm motor function and daily function remain controversial.

OBJECTIVE

To evaluate the effect of adding trunk restraint to task-oriented rehabilitation of arm motor function and functional ability after stroke.

METHODS

Nine databases were systematically searched for randomized controlled trials studying the effects of trunk restraint in post-stroke task-oriented training. Researchers assessed methodological qualities using the Physiotherapy Evidence Database scale, and extracted data related to study participants, intervention, and outcomes. The overall effectiveness was calculated using a meta-analytic method.

RESULTS

In total, ten articles met the inclusion criteria and nine trails (n = 255 subjects) were included in quantitative analyses. Meta-analysis revealed that trunk restraint exhibited a significant improvement on the Motor Activity Log-amount of use, 0.39 (95% CI: 0.25- 0.54), the Motor Activity Log-quality of movement, 0.45 (95% CI: 0.27- 0.63), the Fugl-Meyer Assessment (upper extremity), 1.09 (95% CI: 0.67- 1.51), Action Research Arm test, 4.51 (95% CI: 2.49- 6.54) and performance of Activities of daily living, 1.70 (95% CI: 0.19- 3.21) in trunk restraint group in patients at subacute stage, compared to the non-trunk restraint group, but no significant difference was found in patients with chronic stroke.

CONCLUSIONS

Adding trunk restraint to task-oriented training may improve function in patients with subacute stroke.

摘要

背景

躯干约束对脑卒中后手臂运动功能和日常功能的有效性仍存在争议。

目的

评估在脑卒中后任务导向性上肢运动功能和功能能力训练中增加躯干约束的效果。

方法

系统检索了九个数据库,以寻找关于躯干约束对脑卒中后任务导向性训练中手臂运动功能影响的随机对照试验。研究人员使用物理治疗证据数据库量表评估方法学质量,并提取与研究参与者、干预和结局相关的数据。使用荟萃分析方法计算总体效果。

结果

共有 10 篇文章符合纳入标准,9 项试验(n=255 名受试者)纳入定量分析。荟萃分析显示,躯干约束在运动日志-使用量、0.39(95%CI:0.25-0.54)、运动日志-运动质量、0.45(95%CI:0.27-0.63)、Fugl-Meyer 评估(上肢)、1.09(95%CI:0.67-1.51)、动作研究手臂测试、4.51(95%CI:2.49-6.54)和日常生活活动表现、1.70(95%CI:0.19-3.21)方面,对亚急性期患者的上肢功能有显著改善,与非躯干约束组相比,但在慢性期脑卒中患者中未发现显著差异。

结论

在任务导向性训练中增加躯干约束可能会改善亚急性期脑卒中患者的功能。

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