Feys H M, De Weerdt W J, Selz B E, Cox Steck G A, Spichiger R, Vereeck L E, Putman K D, Van Hoydonck G A
Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, University of Leuven, Belgium.
Stroke. 1998 Apr;29(4):785-92. doi: 10.1161/01.str.29.4.785.
Arm function recovery is notoriously poor in stroke patients. The effect of treatment modalities, particularly those directed at improving upper limb function, has been studied primarily in chronic stroke patients. The purpose of this study was to investigate the effect of a specific therapeutic intervention on arm function in the acute phase after stroke.
In a single-blind, randomized, controlled multicenter trial, 100 consecutive patients were allocated to either an experimental group that received an additional treatment of sensorimotor stimulation or to a control group. The intervention was applied for 6 weeks. Patients were evaluated for level of impairment (Brunnström-Fugl-Meyer test) and disability (Action Research Arm test, Barthel Index) before, midway, and after the intervention period and at follow-up 6 and 12 months after stroke.
Patients in the experimental group performed better on the Brunnström-Fugl-Meyer test than those in the control group throughout the study period, but differences were significant only at follow-up. Results on the Action Research Arm test and Barthel Index revealed no effect at the level of disability. The effect of the therapy was attributed to the repetitive stimulation of muscle activity. The treatment was most effective in patients with a severe motor deficit and hemianopia or hemi-inattention. No adverse effects due to the intervention were found.
Adding a specific intervention during the acute phase after stroke improved motor recovery, which was apparent 1 year later. These results emphasize the potential beneficial effect of therapeutic interventions for the arm.
众所周知，中风患者的上肢功能恢复情况很差。治疗方式的效果，尤其是那些旨在改善上肢功能的方式，主要是在慢性中风患者中进行研究的。本研究的目的是调查一种特定治疗干预对中风急性期上肢功能的影响。
在一项单盲、随机、对照的多中心试验中，100例连续患者被分配到接受感觉运动刺激额外治疗的实验组或对照组。干预持续6周。在干预期之前、中期和之后以及中风后6个月和12个月的随访中，对患者的损伤程度（Brunnström-Fugl-Meyer测试）和残疾情况（行动研究上肢测试、Barthel指数）进行评估。
在整个研究期间，实验组患者在Brunnström-Fugl-Meyer测试中的表现优于对照组，但差异仅在随访时显著。行动研究上肢测试和Barthel指数的结果显示在残疾水平上没有效果。该治疗的效果归因于对肌肉活动的重复刺激。该治疗对有严重运动缺陷和偏盲或半侧忽视的患者最有效。未发现因干预导致的不良反应。
在中风急性期增加特定干预可改善运动恢复，这在1年后很明显。这些结果强调了针对上肢的治疗干预的潜在有益效果。
