Lee Meng-Ta, Chen Chih-Chi, Lu Hsuan-Lun, Hsieh Yu-Wei
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
Digit Health. 2024 Jun 5;10:20552076241260536. doi: 10.1177/20552076241260536. eCollection 2024 Jan-Dec.
Technologically adapted mirror therapy shows promising results in improving motor function for stroke survivors. The treatment effects of a newly developed multi-mode stroke rehabilitation system offering multiple training modes in digital mirror therapy remain unknown. This study aimed to examine the effects of unilateral mirror visual feedback (MVF) with unimanual training (UM-UT), unilateral MVF with bimanual training (UM-BT), and bilateral MVF with bimanual training (BM-BT) on clinical outcomes in stroke survivors, compared to classical mirror therapy (CMT).
Thirty-five participants were randomly assigned to one of four groups receiving fifteen 60-minute training sessions for 3-4 weeks. The Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Chedoke Arm and Hand Activity Inventory (CAHAI), Revised Nottingham Sensory Assessment (rNSA), Motor Activity Log (MAL), and EQ-5D-5L were administered at pre- and post-intervention and at 1-month follow-up.
After intervention and follow-up, significant within-group treatment efficacies were found on most primary outcomes of the FMA-UE and CAHAI scores in all four groups. Significant within-group improvements in the secondary outcomes were found on the MAL and EQ-5D-5L index in the UM-BT group, and the rNSA tactile sensation and MAL quality of movement subscales in the BM-BT group. No significant between-group treatment efficacies were found.
UM-UT, UM-BT, BM-BT, and CMT led to similar clinical effects on the FMA-UE and can be considered effective alternative interventions for post-stroke upper-limb motor rehabilitation. UM-BT and BM-BT showed within-group improvements in functional performance in the patients' affected upper limbs in real-life activities.
技术改良后的镜像疗法在改善中风幸存者的运动功能方面显示出了有前景的结果。一种新开发的在数字镜像疗法中提供多种训练模式的多模式中风康复系统的治疗效果仍不明确。本研究旨在探讨与传统镜像疗法（CMT）相比，单镜视觉反馈（MVF）结合单手训练（UM-UT）、单镜视觉反馈结合双手训练（UM-BT）以及双镜视觉反馈结合双手训练（BM-BT）对中风幸存者临床结局的影响。
35名参与者被随机分配到四组中的一组，接受为期3 - 4周、共15次每次60分钟的训练课程。在干预前、干预后以及1个月随访时，进行上肢Fugl-Meyer评估（FMA-UE）、Chedoke手臂和手部活动量表（CAHAI）、修订的诺丁汉感觉评估（rNSA）、运动活动日志（MAL）以及EQ-5D-5L评估。
干预和随访后，在所有四组中，FMA-UE和CAHAI评分的大多数主要结局指标均显示出显著的组内治疗效果。UM-BT组在次要结局指标MAL和EQ-5D-5L指数上有显著的组内改善，BM-BT组在rNSA触觉感觉和MAL运动质量子量表上有显著的组内改善。未发现显著的组间治疗效果。
UM-UT、UM-BT、BM-BT和CMT对FMA-UE产生了相似的临床效果，可被视为中风后上肢运动康复的有效替代干预措施。UM-BT和BM-BT在患者受影响上肢的实际生活活动功能表现方面显示出组内改善。
