三维手指力量控制的生物反馈训练改善中风后上肢功能：一项随机对照试验。
Biofeedback Training for 3-Dimensional Finger Force Control to Improve Upper Limb Function Poststroke: An RCT.
作者信息
Seo Na Jin, Schranz Christian, Coupland Kristen, Blaschke Jenna, Scronce Gabrielle, Finetto Christian, Baker Adam, Gallant Ja'Quann, Alston Arianna, Howard Keith, Thompson Devin, Ramakrishnan Viswanathan, Holmstedt Christine A, Kamper Derek G
机构信息
Ralph H. Johnson Veterans Affairs Health Care System, Charleston, SC (N.J.S., C.S., K.C., J.B., G.S., C.F., A.B., J.G., A.A., K.H., D.T., V.R.).
Division of Occupation Therapy, Department of Rehabilitation Sciences (N.J.S), Medical University of South Carolina, Charleston.
出版信息
Stroke. 2025 Aug;56(8):2266-2276. doi: 10.1161/STROKEAHA.125.050965. Epub 2025 May 22.
BACKGROUND
After stroke, impairment of hand sensorimotor control leads to improperly scaled and directed fingertip forces that disrupt object manipulation. The objective of this study was to determine the efficacy of finger force magnitude and direction training using 3-dimensional versus 1-dimensional biofeedback to enhance poststroke upper extremity motor recovery.
METHODS
A double-blind randomized controlled trial took place in the Veterans Affairs laboratory from 2020 to 2023. Forty-five stroke survivors were randomly assigned to the experimental or control group. Both groups received 18 training sessions to generate digit force in the target magnitude and direction. The experimental group trained with visual feedback on the digit force magnitude in 3 dimensions. The control group trained with 1-dimensional visual feedback on the digit force magnitude along the target direction only. The primary outcome was the change in upper extremity function assessed using the Action Research Arm Test post-intervention.
RESULTS
Baseline characteristics were comparable between the groups (mean age, 59 years, 60% male, 40% Black people). The change between pretraining and posttraining Action Research Arm Test scores was significantly greater for the experimental group than for the control group (experimental mean, 3.5 [CI, 2.2-4.8] versus control mean, 0.8 [CI, -0.5 to 2.1]; =0.005). This difference was maintained at 1-month follow-up. Secondary analysis showed that individuals in the experimental group whose stroke occurred within a year prior improved more (mean, 6.1 [CI, 4.0-8.3]) than others (<0.003).
CONCLUSIONS
Force direction feedback led to improved upper extremity motor recovery in stroke survivors. This biofeedback-based treatment may provide the needed explicit training in force direction control for more effective hand rehabilitation.
REGISTRATION
URL: https://www.clinicaltrials.gov; Unique identifier: NCT03995069.
背景
中风后，手部感觉运动控制受损会导致指尖力量的大小和方向调整不当，从而干扰物体的操作。本研究的目的是确定使用三维与一维生物反馈进行手指力量大小和方向训练对增强中风后上肢运动恢复的疗效。
方法
2020年至2023年在退伍军人事务实验室进行了一项双盲随机对照试验。45名中风幸存者被随机分配到实验组或对照组。两组均接受18次训练，以产生目标大小和方向的手指力量。实验组在三维空间中接受关于手指力量大小的视觉反馈训练。对照组仅在目标方向上接受关于手指力量大小的一维视觉反馈训练。主要结局是干预后使用动作研究臂测试评估的上肢功能变化。
结果
两组的基线特征具有可比性（平均年龄59岁，60%为男性，40%为黑人）。实验组训练前和训练后动作研究臂测试分数的变化显著大于对照组（实验组平均值为3.5[可信区间，2.2 - 4.8]，对照组平均值为0.8[可信区间，-0.5至2.1]；P = 0.005）。这种差异在1个月的随访中得以维持。二次分析表明，中风发生在一年之内的实验组个体改善更大（平均值为6.1[可信区间，4.0 - 8.3]），优于其他个体（P < 0.003）。
结论
力量方向反馈可改善中风幸存者的上肢运动恢复。这种基于生物反馈的治疗方法可能为更有效的手部康复提供所需的力量方向控制明确训练。
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