Physical medicine and rehabilitation department, National university hospital of Cotonou, Cotonou, Benin; NMSK lab, Institut de recherche expérimentale et clinique (IREC), UCLouvain, Brussels, Belgium.
NMSK lab, Institut de recherche expérimentale et clinique (IREC), UCLouvain, Brussels, Belgium; Physical medicine and rehabilitation department, cliniques universitaires Saint-Luc, Brussels, Belgium; Louvain Bionics, UCLouvain, Louvain-La-Neuve, Belgium.
Ann Phys Rehabil Med. 2021 Jan;64(1):101413. doi: 10.1016/j.rehab.2020.03.017. Epub 2020 Oct 15.
About two-thirds of stroke patients present long-term upper-limb impairment and limitations of activity, which constitutes a challenge in rehabilitation. This situation is particularly true in developing countries, where there is a need for inexpensive rehabilitation solutions.
This study assessed the effectiveness of a self-rehabilitation program including uni- or bi-manual functional exercises for improving upper-limb function after stroke with respect to the context in Benin, West Africa.
In this single-blind randomized controlled trial, chronic stroke individuals (>6 months post-stroke) performed a supervised home-based self-rehabilitation program for 8 weeks (intervention group); the control group did not receive any treatment. Participants were assessed before treatment (T0), at the end of treatment (T1) and 8 weeks after the end of treatment (T2). The primary outcome was the manual ability of the upper limb, assessed with ABILHAND-Stroke Benin. Secondary outcomes were grip force, motor impairment (Fugl-Meyer Assessment - Upper Extremity), gross manual ability (Box and Block test, Wolf Motor Function test) and quality of life (WHOQOL-26).
We included 28 individuals in the intervention group and 31 in the control group. Adherence to the program was 83%. After 8 weeks of self-rehabilitation, individuals in the intervention group showed significantly improved manual ability and grip force as compared with the control group (P<0.001), with effect size 0.75 and 0.24, respectively. In the intervention group, the difference in average scores was 10% between T0 and T1 and between T0 and T2. Subscores of physical and psychological quality of life were also significantly improved in the intervention group. The other variables remained unchanged.
A self-rehabilitation program was effective in improving manual ability, grip force and quality of life in individuals with stroke in Benin. More studies are needed to confirm these results in different contexts.
大约三分之二的中风患者存在长期上肢功能障碍和活动受限，这在康复方面构成了挑战。在发展中国家，这种情况尤其如此，因为这些国家需要廉价的康复解决方案。
本研究评估了一种包括单/双手功能练习的自我康复方案在改善贝宁（西非国家）中风患者上肢功能方面的有效性。
在这项单盲随机对照试验中，慢性中风患者（>6 个月）接受了 8 周的家庭监督自我康复方案（干预组）；对照组未接受任何治疗。参与者在治疗前（T0）、治疗结束时（T1）和治疗结束后 8 周（T2）进行评估。主要结局是上肢的手动能力，使用 ABILHAND-Stroke Benin 进行评估。次要结局是握力、运动障碍（Fugl-Meyer 评估-上肢）、粗大手动能力（盒子和木块测试、Wolf 运动功能测试）和生活质量（WHOQOL-26）。
我们纳入了 28 名干预组患者和 31 名对照组患者。该方案的依从率为 83%。经过 8 周的自我康复，干预组患者的手动能力和握力明显优于对照组（P<0.001），效应量分别为 0.75 和 0.24。在干预组中，T0 与 T1 之间以及 T0 与 T2 之间的平均评分差异为 10%。干预组的生理和心理生活质量的亚评分也有显著改善。其他变量保持不变。
自我康复方案在改善贝宁中风患者的手动能力、握力和生活质量方面是有效的。需要更多的研究来确认这些结果在不同背景下的有效性。
