Modified constraint-induced therapy in acute stroke: A randomized controlled pilot study
Modified constraint-induced therapy in acute stroke: A randomized controlled pilot study
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DOI：
10.1177/1545968304272701
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发表时间：
2005-03-01
影响因子：
4.2
通讯作者：
Leonard, AC
中科院分区：
文献类型：
--
作者：
Page, SJ;Levine, P;Leonard, AC
背景与目的：探讨改良约束诱导治疗（mCIT）治疗急性脑卒中上肢偏瘫患者的可行性，并与传统康复治疗（TR）的疗效进行比较。方法。前后对照，多基线，随机对照试验研究。设置。Rebabilitation医院。病人。10例卒中患者卒中后< 14 d，表现为上肢偏瘫和患肢不能使用。干预措施。5名患者接受mCIT治疗，包括结构化治疗，强调在有价值的活动中更多地使用受影响的手臂，每周3天，持续10周，每周5天，持续5周。其他5名患者接受1/2次传统的受影响手臂运动康复，包括受影响肢体的手工灵活性练习和拉伸，以及未受影响肢体的代偿策略。TR方案每周进行3天，持续10周。主要结果测量。Fugl-Meyer运动恢复评估（Fugl-Meyer），动作研究臂测试（ARA）和运动活动日志（MAL）。结果。在干预前，所有患者表现出稳定的运动缺陷和更多的手臂不能使用。干预后，mCIT患者受影响的手臂使用增加（MAL使用量量表+ 2.43），Fugl-Meyer和ARA均增加（平均变化得分分别为+ 18.7和+ 21.7），并且能够再次进行有价值的活动。TR患者在患肢使用方面表现出名义上的改变(+ 0。(7)， Fugl-Meyer和ARA变化不大（分别为+ 4.4和+ 4.8）。Fugl-Meyer和ARA变化仅在nCIT组有统计学意义（P < 0.01）。结论。mCIT是一种很有前途的治疗方案，可以改善急性脑血管意外患者的肢体使用和功能。然而，需要进行更大规模的确证性研究。
Background and Purpose, To determine modified constraint-induced therapy (mCIT) feasibility and compare its efficacy to traditional rehabilitation (TR) in acute stroke patients exhibiting upper limb hemiparesis. Method. Before-after, multiple baseline, randomized controlled pilot study. Setting. Rebabilitation hospital. Patients. Ten stroke patients < 14 d poststroke and exhibiting upper limb hemiparesis and affected limb nonuse. Interventions. Five patients were administered)mCIT consisting of structured therapy emphasizing more affected arm use in valued activities 3 d/week for 10 weeks and less affected arm restraint 5 d/week for 5 b. Five other patients received 1/2 sessions of traditional motor rebabilitation for The affected arm, which included affected limb manual dexterity exercises and stretching, as well as compensatory strategies with the unaffected limb. The TR regimens occurred 3 d/week for 10 weeks. Main Outcome Measures. The Fugl-Meyer Assessment of Motor Recoveiy (Fugl-Meyer), Action Research Arm Test (ARA), and Motor Activity Log (MAL). Results. Before intervention, all patients exhibited stable motor deficits and more affected arm nonuse. After intervention, mCIT patients displayed increase affected arm use (+ 2.43 on the MAL amount of use scale), uniformly exhibited increases on the Fugl-Meyer and ARA (mean change scores = + 18.7 and + 21.7, respectively), and were able to again perform valued activities. TR patients exbibited nominal change in affected limb use (+ 0. 07on the MAL amount of use scale) and modest changes on the Fugl-Meyer and ARA (+ 4.4 and + 4.8, respectively). Fugl-Meyer and ARA changes were significant for the nCIT group only (P < 0.01). Conclusions. mCIT is a promising regimen for improving more affected limb use and function in acute cerebrovascular accident. However, larger confirmatory studies need to performed.