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不同设计的压力衣对中风后上肢感觉运动功能和生活质量的影响:一项多中心、双盲、前瞻性随机对照试验的研究方案

Effects of pressure garments of varying designs on upper extremity sensorimotor functions and quality of life after stroke: Study protocol for a multicenter, double-blind, prospective randomized controlled trial.

作者信息

Xu Zhenkun, Chai Siaw Chui, Chu Shin Ying, Li Kuicheng

机构信息

Center for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Center for Health Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

出版信息

PLoS One. 2025 Jun 23;20(6):e0326680. doi: 10.1371/journal.pone.0326680. eCollection 2025.

Abstract

RATIONALE

Stroke often results in extensive neurological damage, leading to a wide range of rehabilitation needs and challenges, with upper extremity dysfunction being particularly prevalent. Although pressure garments have been used in the rehabilitation of children with cerebral palsy to reduce muscle tone, their therapeutic effects have not been thoroughly investigated in the field of stroke.

AIMS

To determine the effects of pressure garments with varying designs on stroke patients' sensorimotor function and quality of life.

SAMPLE SIZE ESTIMATE

A total of 165 participants is required (55/group) with an effect size of 0.125, power of 0.80, alpha level of 0.05, and adjusted for a dropout rate of 20%.

METHODS AND DESIGN

This is a multicenter, double-blind, prospective randomized controlled, three-group trial. At three hospitals in Shandong, China, 165 patients within 1-12 months of stroke are randomly assigned (1:1:1) to receive Dorsal-Double-layered 10% circumferential reduction (DD-10, intervention), Single-layered 10% circumferential reduction (S-10, intervention), or Single-layered 0% circumferential reduction (S-0, placebo) pressure garments. Pressure garments are worn for 3 hours in the morning, 3 hours in the afternoon, and 8 hours at night daily for 8 weeks. During the first 4 weeks, patients also receive 30-min occupational therapy sessions.

STUDY OUTCOMES

The primary outcome is the Fugl-Meyer Assessment of Upper Extremity to assess motor control. Secondary outcomes are the Box and Block Test (BBT) for assessing dexterity, Modified Ashworth Scale (MAS) for assessing muscle tone, Visual Analogue Scale for assessing pain, Disabilities of Arm, Shoulder, and Hand (DASH) for assessing self-perceived upper extremity function, and 36 Item Short Health Survey (SF-36) for assessing quality of life. Measurements are taken at Time 1(Baseline), Time 2 (Week 4), and Time 3 (Week 8).

DISCUSSION

The expected outcome of this study is that it can determine the design of pressure garments best suited to improve sensorimotor function and the quality of life of stroke patients. It can also extend the clinical value of pressure garments and help healthcare professionals make more targeted treatment choices for stroke patients.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT06587308.

摘要

原理

中风常导致广泛的神经损伤,引发各种康复需求和挑战,其中上肢功能障碍尤为普遍。尽管压力衣已用于脑瘫儿童的康复以降低肌张力,但其在中风领域的治疗效果尚未得到充分研究。

目的

确定不同设计的压力衣对中风患者感觉运动功能和生活质量的影响。

样本量估计

共需要165名参与者(每组55名),效应量为0.125,检验效能为0.80,α水平为0.05,并针对20%的失访率进行调整。

方法与设计

这是一项多中心、双盲、前瞻性随机对照三组试验。在中国山东的三家医院,将165例中风后1至12个月内的患者随机分配(1:1:1),分别接受背部双层圆周缩减10%(DD - 10,干预组)、单层圆周缩减10%(S - 10,干预组)或单层圆周缩减0%(S - 0,安慰剂组)的压力衣。压力衣每天上午穿3小时,下午穿3小时,晚上穿8小时,共穿8周。在最初4周内,患者还接受30分钟的职业治疗课程。

研究结果

主要结果是用Fugl - Meyer上肢评估法评估运动控制。次要结果包括用于评估灵活性的箱块测试(BBT)、用于评估肌张力的改良Ashworth量表(MAS)、用于评估疼痛的视觉模拟量表、用于评估自我感知上肢功能的手臂、肩部和手部功能障碍量表(DASH)以及用于评估生活质量的36项简短健康调查问卷(SF - 36)。在时间1(基线)、时间2(第4周)和时间3(第8周)进行测量。

讨论

本研究的预期结果是能够确定最适合改善中风患者感觉运动功能和生活质量的压力衣设计。它还可以扩展压力衣的临床价值,并帮助医疗保健专业人员为中风患者做出更有针对性的治疗选择。

试验注册

ClinicalTrials.gov标识符:NCT06587308。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4015/12184997/98207bb9420a/pone.0326680.g001.jpg

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