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任务导向镜像疗法增强亚急性期脑卒中患者上肢运动功能:一项随机对照试验。

Task-based mirror therapy enhances the upper limb motor function in subacute stroke patients: a randomized control trial.

机构信息

Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China -

出版信息

Eur J Phys Rehabil Med. 2020 Jun;56(3):265-271. doi: 10.23736/S1973-9087.20.06070-0. Epub 2020 Mar 25.

Abstract

BACKGROUND

The improvement of the upper limb disability, which is mainly caused by stroke, is still one of the rehabilitation treatment challenges. However, the effectiveness of task-based mirror therapy (TBMT) on subacute stroke with moderate and severe upper limb impairment has not been deeply explored.

AIM

The purpose of this study was to investigate the effects of TBMT, in comparison to occupational therapy, in moderate and severe upper limb impairment by analyzing the motor function and activities of daily living in subacute stroke patients.

DESIGN

A randomized controlled trial.

SETTING

Rehabilitative inpatient unit.

POPULATION

Thirty patients with moderate and severe-subacute stroke recruited from the Second Affiliated Hospital of Chongqing Medical University have been randomly divided into two groups; the task-based mirror therapy group (N.=15) and the control group (N.=15).

METHODS

The first group received TBMT while the control group only underwent only occupational therapy without a mirror utilization. Taking into consideration that both groups received conventional therapy. The intervention time was equal for both groups consisting of 25 minutes per day for 25 days. Fugl-Meyer Assessment (FMA), Brunnstrom Assessment (BRS), Modified Barthel Index (MBI), and Modified Ashworth Scale (MAS) were used to assess the outcomes for this study.

RESULTS

After 25 sessions of treatment, the patients in both groups have shown-improvement in the activates of daily living, motor recovery, and motor function. No significant differences between the two groups were observed on BRS and MBI. However, interestingly, the results of the TBMT group were significantly better than the control group in FMA (P<0.05) and certain aspects of MAS (elbow flexion, wrist flexion, wrist extension, and fingers extension with P<0.05).

CONCLUSIONS

This study shows that the combination of conventional rehabilitation treatment and TBMT is an effective way to improve the functional recovery in the upper limb stroke patients.

CLINICAL REHABILITATION IMPACT

TBMT is a therapeutic technique that can be used in subacute stroke patients with moderate and severe upper limb impairment.

摘要

背景

上肢功能障碍的改善,主要是由中风引起的,仍然是康复治疗的挑战之一。然而,任务为基础的镜像治疗(TBMT)对中重度上肢运动功能障碍的亚急性中风的疗效尚未得到深入探讨。

目的

本研究旨在通过分析亚急性中风患者的运动功能和日常生活活动,比较 TBMT 与作业疗法对中重度上肢运动功能障碍的影响。

设计

随机对照试验。

设置

康复住院病房。

人群

从重庆医科大学第二附属医院招募了 30 名中重度亚急性中风患者,将他们随机分为两组:任务为基础的镜像治疗组(N=15)和对照组(N=15)。

方法

第一组接受 TBMT,而对照组仅接受常规治疗,不使用镜像。考虑到两组都接受了常规治疗,两组的干预时间相同,每天 25 分钟,共 25 天。采用 Fugl-Meyer 评估(FMA)、Brunnstrom 评估(BRS)、改良巴氏指数(MBI)和改良 Ashworth 量表(MAS)评估研究结果。

结果

经过 25 个疗程的治疗,两组患者的日常生活活动、运动功能和运动恢复均有改善。两组在 BRS 和 MBI 上无显著差异。然而,有趣的是,TBMT 组在 FMA(P<0.05)和 MAS 的某些方面(肘、腕关节屈曲,腕关节伸展和手指伸展)的结果明显优于对照组(P<0.05)。

结论

本研究表明,常规康复治疗联合 TBMT 是一种有效改善中风患者上肢功能恢复的方法。

临床康复影响

TBMT 是一种治疗技术,可用于中重度上肢运动功能障碍的亚急性中风患者。

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