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智能手套用于亚急性脑卒中患者上肢康复的效果:一项提前终止的多中心随机对照试验的结果

Effects of Upper-Extremity Rehabilitation Using Smart Glove in Patients With Subacute Stroke: Results of a Prematurely Terminated Multicenter Randomized Controlled Trial.

作者信息

Kang Min-Gu, Yun Seo Jung, Lee Sang Yoon, Oh Byung-Mo, Lee Hyun Haeng, Lee Shi-Uk, Seo Han Gil

机构信息

Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.

Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea.

出版信息

Front Neurol. 2020 Nov 9;11:580393. doi: 10.3389/fneur.2020.580393. eCollection 2020.

Abstract

Although there have been many trials and interventions for reducing upper-extremity impairment in stroke survivors, it remains a challenge. A novel intervention is needed to provide high-repetition task-specific training early after stroke. This study aimed to investigate the effect of smart glove training (SGT) for upper-extremity rehabilitation in patients with subacute stroke. A prospective, multicenter, randomized, controlled study was conducted in patients with upper-extremity hemiparesis with Brunnstrom stage for arm 2-5 in the subacute phase after stroke. Eligible participants were randomly allocated to the SGT group or the control group. The SGT group underwent 30 min of standard occupational therapy plus 30 min of upper-extremity training with smart glove. The control group underwent standard occupational therapy for 30 min plus upper-extremity self-training (homework tasks at bedside) for 30 min. All participants underwent each intervention 5 days/week for 2 consecutive weeks. They were evaluated before, immediately after, and 4 weeks after the intervention. The primary outcome measure was the change in the score of the Fugl-Meyer assessment of the upper extremity (FMA-UE). Twenty-three patients were enrolled. Repeated-measures analysis of covariance after controlling for age and disease duration showed significant time × group interaction effects in the FMA-UE, FMA-distal, and FMA-coordination/speed ( = 0.018, = 0.002, = 0.006). Repeated-measures analysis of variance showed significant time × group interaction effects in the FMA-UE, FMA-distal, and Box and Block Test ( = 0.034, = 0.010, = 0.046). Mann-Whitney -test showed a statistically higher increase in the FMA-UE and FMA-distal in the SGT group than in the control group ( = 0.023, = 0.032). Upper-extremity rehabilitation with a smart glove may reduce upper-extremity impairment in patients with subacute stroke. : ClinicalTrials.gov (NCT02592759).

摘要

尽管已经有许多针对减轻中风幸存者上肢功能障碍的试验和干预措施,但这仍然是一个挑战。需要一种新的干预措施,以便在中风后早期提供高重复性的特定任务训练。本研究旨在调查智能手套训练(SGT)对亚急性中风患者上肢康复的效果。对中风亚急性期上肢偏瘫且上肢Brunnstrom分期为2 - 5期的患者进行了一项前瞻性、多中心、随机对照研究。符合条件的参与者被随机分配到SGT组或对照组。SGT组接受30分钟的标准职业治疗加30分钟的智能手套上肢训练。对照组接受30分钟的标准职业治疗加30分钟的上肢自我训练(床边家庭作业任务)。所有参与者每周进行5天干预,连续进行2周。在干预前、干预后立即以及干预后4周对他们进行评估。主要结局指标是上肢Fugl - Meyer评估(FMA - UE)得分的变化。共纳入23例患者。在控制年龄和病程后进行的重复测量协方差分析显示,在FMA - UE、FMA - 远端和FMA - 协调/速度方面存在显著的时间×组交互效应(P = 0.018,P = 0.002,P = 0.006)。重复测量方差分析显示,在FMA - UE、FMA - 远端和箱块测试方面存在显著的时间×组交互效应(P = 0.034,P = 0.010,P = 0.046)。Mann - Whitney U检验显示,SGT组FMA - UE和FMA - 远端的增加在统计学上高于对照组(P = 0.023,P = 0.032)。使用智能手套进行上肢康复可能会减轻亚急性中风患者的上肢功能障碍。试验注册号:ClinicalTrials.gov(NCT02592759)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ed/7680863/727b894a7e4c/fneur-11-580393-g0001.jpg

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