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在治疗过程中同时进行感觉刺激,以增强脑卒中后手的功能恢复。

Concomitant sensory stimulation during therapy to enhance hand functional recovery post stroke.

机构信息

Department of Rehabilitation Sciences, Department of Health Science and Research, Medical University of South Carolina, 151B Rutledge Ave, MSC 962, Charleston, SC, 29425, USA.

Ralph H. Johnson VA Medical Center, Charleston, SC, USA.

出版信息

Trials. 2022 Apr 5;23(1):262. doi: 10.1186/s13063-022-06241-9.

Abstract

BACKGROUND

Post-stroke hand impairment is prevalent and persistent even after a full course of rehabilitation. Hand diminishes stroke survivors' abilities for activities of daily living and independence. One way to improve treatment efficacy is to augment therapy with peripheral sensory stimulation. Recently, a novel sensory stimulation, TheraBracelet, has been developed in which imperceptible vibration is applied during task practice through a wrist-worn device. The objective of this trial is to determine if combining TheraBracelet with hand task practice is superior to hand task practice alone.

METHODS

A double-blind randomized controlled trial will be used. Chronic stroke survivors will undergo a standardized hand task practice therapy program (3 days/week for 6 weeks) while wearing a device on the paretic wrist. The device will deliver TheraBracelet vibration for the treatment group and no vibration for the control group. The primary outcome is hand function measured by the Wolf Motor Function Test. Other outcomes include the Box and Block Test, Action Research Arm Test, upper extremity use in daily living, biomechanical measure of the sensorimotor grip control, and EEG-based neural communication.

DISCUSSION

This research will determine clinical utility of TheraBracelet to guide future translation. The TheraBracelet stimulation is delivered via a wrist-worn device, does not interfere with hand motion, and can be easily integrated into clinical practice. Enhancing hand function should substantially increase stroke survivors' independence and quality of life and reduce caregiver burden.

TRIAL REGISTRATION

NCT04569123 . Registered on September 29, 2020.

摘要

背景

即使经过完整的康复治疗,中风后手功能障碍仍然普遍且持久。手部功能的丧失降低了中风幸存者日常生活活动和独立能力。提高治疗效果的一种方法是通过外周感觉刺激来增强治疗。最近,开发了一种新型感觉刺激疗法TheraBracelet,通过佩戴在手腕上的设备在进行手部任务练习时施加不可察觉的振动。本试验的目的是确定 Therabracelet 与手部任务练习相结合是否优于单独进行手部任务练习。

方法

将采用双盲随机对照试验。慢性中风幸存者将在手部患病侧手腕上佩戴设备,接受标准化的手部任务练习治疗方案(每周 3 天,持续 6 周)。治疗组设备将提供 Therabracelet 振动,对照组则无振动。主要结局指标是手部功能,采用 Wolf 运动功能测试进行评估。其他结局指标包括 Box 和 Block 测试、动作研究上肢测试、日常生活上肢使用、感觉运动抓握控制的生物力学测量以及基于脑电图的神经通讯。

讨论

本研究将确定 Therabracelet 的临床应用价值,以指导未来的转化研究。Therabracelet 刺激通过手腕佩戴的设备传递,不会干扰手部运动,并且易于整合到临床实践中。增强手部功能应该会大大提高中风幸存者的独立性和生活质量,并减轻照顾者的负担。

试验注册

NCT04569123。注册于 2020 年 9 月 29 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c30a/8981949/0827f41ea22f/13063_2022_6241_Fig1_HTML.jpg

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