The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia; Faculty of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia; National Health and Medical Research Council Stroke Rehabilitation and Brain Recovery Centre of Research Excellence, The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
College of Health and Medicine, University of Tasmania, Launceston, Australia; Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
Arch Phys Med Rehabil. 2020 Jul;101(7):1131-1137. doi: 10.1016/j.apmr.2020.03.011. Epub 2020 Apr 10.
OBJECTIVE: To investigate the STRoke Interactive Virtual thErapy (STRIVE) intervention on upper-extremity clinical outcomes in community-dwelling stroke survivors. DESIGN: Assessor-blinded randomized controlled trial. SETTING: Study screening and testing was conducted in a university clinic. Participants completed the virtual therapy (VT) intervention in a community-based stroke support group setting. PARTICIPANTS: Of 124 stroke survivors initially assessed, 60 participants were recruited (time poststroke, 13.4±8.9 y). Participants were allocated to either VT or control group using a block randomization design and were stratified by sex. INTERVENTIONS: Participants were randomized to receive 8 weeks of VT or usual care. The intervention consisted of approximately 45 minutes of twice weekly VT training on the Jintronix Rehabilitation System. MAIN OUTCOME MEASURES: Between-group differences in the Fugl-Meyer Upper Extremity scale and Action Research Arm Test score were joint primary outcomes in this study. RESULTS: Significant between-group differences for the Fugl-Meyer Upper Extremity scale were seen at the end of the intervention (F=5.37, P=.02, d=0.41). No significant differences were observed with the Action Research Arm Test. No adverse events were reported. CONCLUSIONS: We demonstrated clinically meaningful improvements in gross upper extremity motor function and use of the affected arm after a VT intervention delivered via a community-based stroke support group setting. This data adds to the contexts in which VT can be used to improve upper limb function. Use of VT in community-based rehabilitation in chronic stroke recovery is supported.
目的:研究 STRoke 互动虚拟治疗(STRIVE)对社区居住的中风幸存者上肢临床结果的影响。
设计:评估员盲法随机对照试验。
地点:研究筛选和测试在一所大学诊所进行。参与者在社区为基础的中风支持小组环境中完成虚拟治疗(VT)干预。
参与者:在最初评估的 124 名中风幸存者中,有 60 名参与者被招募(中风后时间为 13.4±8.9 年)。参与者使用分组随机设计分配到 VT 或对照组,并按性别分层。
干预:参与者随机接受 8 周的 VT 或常规护理。干预包括每周两次在 Jintronix 康复系统上进行大约 45 分钟的 VT 训练。
主要观察指标:本研究的主要联合结局是 Fugl-Meyer 上肢量表和动作研究上肢测试评分的组间差异。
结果:干预结束时,Fugl-Meyer 上肢量表的组间差异显著(F=5.37,P=.02,d=0.41)。动作研究上肢测试未见显著差异。未报告不良事件。
结论:我们证明了通过社区为基础的中风支持小组环境提供的 VT 干预后,上肢运动功能和患侧手臂使用方面有明显的临床意义改善。这些数据增加了 VT 可用于改善上肢功能的环境。支持在慢性中风康复中使用 VT 进行社区为基础的康复。
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