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联合高剂量疗法、双侧运动预激活和迷走神经刺激治疗慢性卒中幸存者的偏瘫上肢:关于促进恢复的观点

Combining high dose therapy, bilateral motor priming, and vagus nerve stimulation to treat the hemiparetic upper limb in chronic stroke survivors: a perspective on enhancing recovery.

作者信息

King Erin C, Pedi Elizabeth, Stoykov Mary Ellen, Corcos Daniel M, Urday Sebastian

机构信息

Northwestern University, Evanston, IL, United States.

Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.

出版信息

Front Neurol. 2023 Jun 28;14:1182561. doi: 10.3389/fneur.2023.1182561. eCollection 2023.

DOI:10.3389/fneur.2023.1182561
PMID:37448744
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10336216/
Abstract

Stroke is a leading cause of disability worldwide and upper limb hemiparesis is the most common post-stroke disability. Recent studies suggest that clinically significant motor recovery is possible in chronic stroke survivors with severe impairment of the upper limb. Three promising strategies that have been investigated are (1) high dose rehabilitation therapy (2) bilateral motor priming and (3) vagus nerve stimulation. We propose that the future of effective and efficient upper limb rehabilitation will likely require a combination of these approaches.

摘要

中风是全球致残的主要原因,上肢偏瘫是最常见的中风后残疾。最近的研究表明,上肢严重受损的慢性中风幸存者有可能实现具有临床意义的运动恢复。已被研究的三种有前景的策略是:(1)高剂量康复治疗;(2)双侧运动启动;(3)迷走神经刺激。我们认为,有效且高效的上肢康复未来可能需要这些方法的组合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e78b/10336216/114dac283ae2/fneur-14-1182561-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e78b/10336216/114dac283ae2/fneur-14-1182561-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e78b/10336216/114dac283ae2/fneur-14-1182561-g001.jpg

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本文引用的文献

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Rehabilitation Therapy Doses Are Low After Stroke and Predicted by Clinical Factors.中风后康复治疗剂量低,可由临床因素预测。
Stroke. 2023 Mar;54(3):831-839. doi: 10.1161/STROKEAHA.122.041098. Epub 2023 Feb 3.
2
Effect of Combined Vagus Nerve Stimulation on Recovery of Upper Extremity Function in Patients with Stroke: A Systematic Review and Meta-Analysis.联合迷走神经刺激对脑卒中患者上肢功能恢复的影响:一项系统评价与Meta分析
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The 3-Month Effectiveness of a Stratified Blended Physiotherapy Intervention in Patients With Nonspecific Low Back Pain: Cluster Randomized Controlled Trial.
分层混合物理治疗干预对非特异性下腰痛患者 3 个月疗效的影响:聚类随机对照试验。
J Med Internet Res. 2022 Feb 25;24(2):e31675. doi: 10.2196/31675.
4
A systematic review of randomized controlled trial characteristics for interventions to improve upper extremity motor recovery post stroke.一项针对改善脑卒中后上肢运动功能恢复的干预措施的随机对照试验特征的系统评价。
Top Stroke Rehabil. 2023 May;30(4):323-332. doi: 10.1080/10749357.2022.2035578. Epub 2022 Feb 14.
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Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association.《心脏病与卒中统计-2022 更新:美国心脏协会报告》。
Circulation. 2022 Feb 22;145(8):e153-e639. doi: 10.1161/CIR.0000000000001052. Epub 2022 Jan 26.
6
Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke (VNS-REHAB): a randomised, blinded, pivotal, device trial.迷走神经刺激联合康复治疗缺血性脑卒中后上肢运动功能(VNS-REHAB):一项随机、盲法、关键性、设备试验。
Lancet. 2021 Apr 24;397(10284):1545-1553. doi: 10.1016/S0140-6736(21)00475-X.
7
Study protocol for a pivotal randomised study assessing vagus nerve stimulation during rehabilitation for improved upper limb motor function after stroke.一项关键随机研究的研究方案,该研究评估在中风后康复期间进行迷走神经刺激以改善上肢运动功能。
Eur Stroke J. 2019 Dec;4(4):363-377. doi: 10.1177/2396987319855306. Epub 2019 Jun 17.
8
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Restor Neurol Neurosci. 2020;38(1):11-22. doi: 10.3233/RNN-190943.
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Neurorehabil Neural Repair. 2019 Jul;33(7):523-537. doi: 10.1177/1545968319846120. Epub 2019 May 25.
10
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Front Neurosci. 2019 Mar 29;13:280. doi: 10.3389/fnins.2019.00280. eCollection 2019.