Mark Victor W, Lee Ritalinda D'Andrea, Taub Edward, Uswatte Gitendra
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States.
Arch Rehabil Res Clin Transl. 2021 Nov 12;4(1):100166. doi: 10.1016/j.arrct.2021.100166. eCollection 2022 Mar.
To assess the personal perspectives of persons with multiple sclerosis (MS) on the acceptability of a novel physical therapy program that is designed to transfer gains from the clinic to their real-world lower extremity (LE) use, termed LE constraint-induced therapy (CIT). The program includes several behavior change techniques (prescribed home exercises, daily structured therapist interviews and problem solving for LE activities, keeping an activity diary) and a concentrated physical treatment schedule.
Anonymous internet survey.
Participants accessed the survey from computers in the community.
Five hundred adults (N=500) were recruited from an MS support organization's registry for having indicated from mild to total limb spasticity because they were anticipated to have markedly impaired LE use in the community.
Not applicable.
Participants were offered the options on a nonnumerical Likert scale of "Very likely," "Likely," "Neutral," "Unlikely," or "Very unlikely" to indicate their personal acceptability for each of 5 different key treatment procedures after these were explained. Totals for each option within each key procedure were analyzed for their acceptability.
Of the 281 persons who responded, 90% expressed interest in participating in LE CIT. A large majority of persons who completed the survey selected either "Very likely" or "Likely" for each key procedure (median=88%, range=65%-90%, <.01). This indicated strong acceptance for the procedures of LE CIT. In addition, more respondents who already had had previous physical therapy accepted LE CIT than did respondents who had not had physical therapy (<.01).
The results suggest there is strong acceptance of CIT for mobility with preliminary evidence of benefiting community LE use for persons with MS. The results support further clinical trials of LE CIT for persons with MS.
评估多发性硬化症（MS）患者对一种新型物理治疗方案的个人看法，该方案旨在将临床治疗成果转化为患者在现实世界中下肢的实际使用能力，即下肢强制性运动疗法（LE CIT）。该方案包括多种行为改变技巧（规定的家庭锻炼、治疗师每日进行的结构化访谈以及针对下肢活动的问题解决、记录活动日记）以及密集的物理治疗计划。
匿名网络调查。
参与者通过社区中的计算机访问该调查。
从一个MS支持组织的登记册中招募了500名成年人（N = 500），这些人表示存在从轻度到完全肢体痉挛的情况，因为预计他们在社区中的下肢使用会明显受损。
不适用。
在对5种不同的关键治疗程序进行解释后，让参与者在非数字的李克特量表上选择“非常可能”“可能”“中立”“不太可能”或“非常不可能”，以表明他们对每种程序的个人接受程度。分析每个关键程序中每个选项的总数以评估其可接受性。
在281名回复者中，90%表示有兴趣参与下肢强制性运动疗法。绝大多数完成调查的人对每个关键程序都选择了“非常可能”或“可能”（中位数 = 88%，范围 = 65% - 90%，P <.01）。这表明对下肢强制性运动疗法的程序有强烈的接受度。此外，与未接受过物理治疗的受访者相比，已经接受过物理治疗的受访者对下肢强制性运动疗法的接受度更高（P <.01）。
结果表明，对于行动能力而言，强制性运动疗法获得了强烈认可，初步证据显示其对MS患者在社区中的下肢使用有益。这些结果支持对MS患者进行进一步的下肢强制性运动疗法临床试验。
