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基于本体感觉的训练或改良强制性运动疗法对慢性脑卒中患者上肢运动功能的影响:一项随机对照研究。

Proprioceptive based training or modified constraint-induced movement therapy on upper extremity motor functions in chronic stroke patients: A randomized controlled study.

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.

Private Home Health Services, Istanbul, Turkey.

出版信息

NeuroRehabilitation. 2022;51(2):271-282. doi: 10.3233/NRE-220009.

DOI:10.3233/NRE-220009
PMID:35599504
Abstract

BACKGROUND

The Modified Constraint-Induced Movement Therapy (mCIMT) method is a unilateral training that respectively avoids and activates less affected and affected sides of upper extremities; however, the selected options are not typically ideal. Proprioceptive based training (PT) includes bilateral training methods and influencing proprioceptive receptors.

OBJECTIVE

The primary purpose was to determine if conventional therapy and PT or conventional therapy and mCIMT therapy show similar improvement in patients with chronic stroke. The secondary purpose was to investigate the effectiveness of conventional therapy and PT or mCIMT therapy in patients with chronic stroke and to compare which of the two interventions is more effective.

METHODS

Forty patients with chronic stroke were randomly allocated to only conventional therapy (PTR, n = 14), conventional therapy plus proprioception training (PTR-PT, n = 13), and mCIMT (PTR-mCIMT, n = 13) groups. Evaluations were assessed before and 6 weeks after treatment.

RESULTS

Intragroup evaluations revealeda significant improvement in the all scores in the PTR-PT and PTR-mCMIT groups (p = 0.006 < 0.001). Intergroup comparisons demonstrated that the PTR-mCIMT group had a significant improvement in spasticity and motor function scores compared to the PTR (p < 0.001) and the PTR-PT groups (p = 0.006-0.015).

CONCLUSIONS

PT and mCMIT applied in addition to conventional therapy in patients with chronic stroke were more effective than only conventional therapy. Additionally, mCMIT showed greater improvement in spasticity and motor function scales than PT.

摘要

背景

改良强制性运动疗法(mCIMT)是一种单侧训练,分别避免和激活上肢的非受累侧和受累侧;然而,选择的方案并不理想。本体感觉训练(PT)包括双侧训练方法和影响本体感觉感受器。

目的

主要目的是确定常规治疗和 PT 或常规治疗和 mCIMT 治疗是否对慢性中风患者有相似的改善。次要目的是研究常规治疗和 PT 或 mCIMT 治疗对慢性中风患者的有效性,并比较两种干预措施中哪一种更有效。

方法

40 例慢性中风患者随机分为单纯常规治疗组(PTR,n=14)、常规治疗联合本体感觉训练组(PTR-PT,n=13)和 mCIMT 组(PTR-mCIMT,n=13)。在治疗前和治疗后 6 周进行评估。

结果

组内评估显示,PTR-PT 和 PTR-mCIMT 组的所有评分均有显著改善(p=0.006<0.001)。组间比较显示,与 PTR 组(p<0.001)和 PTR-PT 组(p=0.006-0.015)相比,PTR-mCIMT 组的痉挛和运动功能评分有显著改善。

结论

在慢性中风患者中,除常规治疗外,应用 PT 和 mCIMT 比单纯常规治疗更有效。此外,mCIMT 在改善痉挛和运动功能方面优于 PT。

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