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远程康复与家庭视频运动在杜氏肌营养不良症患者中的比较:一项单盲随机研究。

Comparison of telerehabilitation versus home-based video exercise in patients with Duchenne muscular dystrophy: a single-blind randomized study.

机构信息

Physical Medicine and Rehabilitation Department, Marmara University Medical Faculty, Marmara University Pendik Research and Training Hospital Istanbul, Istanbul, Turkey.

Pediatric Neurology Department, Marmara University Medical Faculty, Istanbul, Turkey.

出版信息

Acta Neurol Belg. 2022 Oct;122(5):1269-1280. doi: 10.1007/s13760-022-01975-4. Epub 2022 May 26.

Abstract

INTRODUCTION

Patients with Duchenne muscular dystrophy (DMD) have lost their access to on-site rehabilitation due to the COVID-19 pandemic. Telerehabilitation can be a viable approach for these patients to protect their muscle strength and functional status. The aim of this study is to compare telerehabilitation with home-based video exercises.

PATIENTS AND METHODS

Male, ambulatory DMD patients were randomized into telerehabilitation and video-exercise groups. Nineteen patients were included in the final analyses. Telerehabilitation consisted of live online exercises, while video exercise implemented a pre-recorded video as a home-based program. Both programs spanned 8 weeks, three times a week. Patients' muscle strength with a hand-held dynamometer, Quick Motor Function Test, North-Star Ambulatory Assessment (NSAA), 6-Minute Walk Test (6MWT) and Caregiver Burden were recorded before and after treatment.

RESULTS

The 6MWT of the telerehabilitation group was391.26 ± 95.08 m before and387.75 ± 210.93 after treatment (p = 0.94) and 327.46 ± 103.88 m before treatment and313.77 ± 114.55 after treatment in video group (p = 0.63). The mean NSAA score of the telerehabilitation group were26.70 ± 8.04 before treatment and 25.20 ± 11.33 after treatment (p = 0.24). In the video group scores were 21.66 ± 6.65 before to 22.00 ± 8.61 after treatment (p = 0.87). There were no significant changes between groups at the end of the treatments. The telerehabilitation group's neck extension, bilateral shoulder abduction, and left shoulder flexion, bilateral knee flexion and extension, bilateral ankle dorsiflexion, and left ankle plantar flexion strength improved significantly and were better than the video group (p < 0.05 for all measurements).

CONCLUSION

A telerehabilitation approach is superior in improving muscle strength than a video-based home exercise, but none of the programs improved functional outcomes in ambulatory patients with DMD.

摘要

简介

由于 COVID-19 大流行,患有杜氏肌营养不良症(DMD)的患者无法进行现场康复治疗。远程康复对于这些患者保护肌肉力量和功能状态可能是一种可行的方法。本研究的目的是比较远程康复与家庭视频锻炼。

患者和方法

男性,可走动的 DMD 患者被随机分为远程康复和视频锻炼组。最终有 19 名患者纳入了最终分析。远程康复包括在线实时锻炼,而视频锻炼则实施了家庭锻炼的预录视频方案。两个方案均持续 8 周,每周 3 次。在治疗前后记录患者的握力(使用手持测力计)、快速运动功能测试、北星门诊评估(NSAA)、6 分钟步行测试(6MWT)和照顾者负担。

结果

远程康复组的 6MWT 治疗前为 391.26±95.08m,治疗后为 387.75±210.93m(p=0.94),治疗前为 327.46±103.88m,治疗后为 313.77±114.55m(p=0.63)。远程康复组的平均 NSAA 评分治疗前为 26.70±8.04,治疗后为 25.20±11.33(p=0.24)。视频组治疗前为 21.66±6.65,治疗后为 22.00±8.61(p=0.87)。治疗结束时,两组之间没有明显变化。远程康复组的颈部伸展、双侧肩部外展、左侧肩部屈曲、双侧膝关节屈伸、双侧踝关节背屈和左侧踝关节跖屈力量明显改善,且优于视频组(所有测量均 p<0.05)。

结论

与基于视频的家庭锻炼相比,远程康复方法在改善肌肉力量方面更具优势,但在改善 DMD 可走动患者的功能结果方面,两种方案均无效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eccc/9133319/81292abcad51/13760_2022_1975_Fig1_HTML.jpg

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