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中风的慢性程度不影响与任务导向性运动训练相结合的体感刺激效果:一项随机对照试验的二次分析

Chronicity of Stroke Does Not Affect Outcomes of Somatosensory Stimulation Paired With Task-Oriented Motor Training: A Secondary Analysis of a Randomized Controlled Trial.

作者信息

Carrico Cheryl, Annichiarico Nicholas, Powell Elizabeth Salmon, Westgate Philip M, Sawaki Lumy

机构信息

Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, Kentucky.

Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky.

出版信息

Arch Rehabil Res Clin Transl. 2019 May 22;1(1-2):100005. doi: 10.1016/j.arrct.2019.100005. eCollection 2019 Jun.

Abstract

OBJECTIVE

To determine whether chronicity influences outcomes of somatosensory stimulation paired with task-oriented motor training for participants with severe-to-moderate upper extremity hemiparesis.

DESIGN

Spearman correlations were used to retrospectively analyze outcomes of a randomized trial.

SETTING

University research laboratory at a rehabilitation hospital.

PARTICIPANTS

Adults, ranging between 3 and 12 months poststroke (N=55).

INTERVENTIONS

About 18 sessions pairing either 2 hours of active (n=33) or sham (n=22) somatosensory stimulation with 4 hours of intensive task-oriented motor training.

MAIN OUTCOME MEASURES

The Wolf Motor Function Test (primary), Action Research Arm Test, Stroke Impact Scale, and Fugl-Meyer Assessment were collected as outcome measures. Analyses evaluated whether within-group chronicity correlated with pre-post changes on primary and secondary outcome measures of motor performance.

RESULTS

Both groups exhibited improvements on all outcome measures. No significant correlations between chronicity poststroke and the amount of motor recovery were found.

CONCLUSION

Somatosensory stimulation improved motor recovery compared with sham treatment in cases of severe-to-moderate hemiparesis between 3 and 12 months poststroke; and the extent of recovery did not correlate with baseline levels of stroke chronicity. Future studies should investigate a wider period of inclusion, patterns of corticospinal reorganization, differences between cortical and subcortical strokes, and include long-term follow-up periods.

摘要

目的

确定对于中重度上肢偏瘫患者,病程长短是否会影响体感刺激与任务导向性运动训练相结合的治疗效果。

设计

采用Spearman相关性分析对一项随机试验的结果进行回顾性分析。

地点

一家康复医院的大学研究实验室。

参与者

中风后3至12个月的成年人(N = 55)。

干预措施

约18节治疗课程,其中一组(n = 33)将2小时的主动体感刺激与4小时的强化任务导向性运动训练配对,另一组(n = 22)将2小时的假体感刺激与4小时的强化任务导向性运动训练配对。

主要结局指标

收集Wolf运动功能测试(主要指标)、动作研究上肢测试、中风影响量表和Fugl-Meyer评估作为结局指标。分析评估组内病程长短与运动表现的主要和次要结局指标的前后变化之间是否存在相关性。

结果

两组在所有结局指标上均有改善。未发现中风后病程长短与运动恢复量之间存在显著相关性。

结论

对于中风后3至12个月的中重度偏瘫患者,与假治疗相比,体感刺激改善了运动恢复;且恢复程度与中风病程的基线水平无关。未来的研究应调查更广泛的纳入期、皮质脊髓重组模式、皮质和皮质下中风之间的差异,并纳入长期随访期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f675/7853359/cb9aac7f0a5c/gr1.jpg

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