Nerve Stimulation Enhances Task-Oriented Training for Moderate-to-Severe Hemiparesis 3-12 Months After Stroke: A Randomized Trial.
Nerve Stimulation Enhances Task-Oriented Training for Moderate-to-Severe Hemiparesis 3-12 Months After Stroke: A Randomized Trial.
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DOI：
10.1097/phm.0000000000000971
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发表时间：
2018-11
影响因子：
3
通讯作者：
Sawaki L
中科院分区：
文献类型：
--
作者：
Carrico C;Westgate PM;Salmon Powell E;Chelette KC;Nichols L;Pettigrew LC;Sawaki L
确定躯体感觉刺激是否影响中风后12个月内中重度上肢偏瘫患者的运动训练结果。55名成年人参加了18次干预，将2小时的积极(n=33)或假的(n=22)体感刺激与4小时的高强度任务导向运动训练配对。在基线、干预后、1个月和4个月的随访中进行Wolf运动功能测试、行动研究手臂测试、Fugl-Meyer评估和卒中影响量表。有统计学意义的组间差异有利于Wolf运动功能测试的活跃状态(p=0.04)和行动研究手臂测试在后1个月(p=0.02)、1个月(p=0.01)和4个月(p=0.01)的活动状态，而在1个月的卒中影响量表(p=0.03)中有利于假状态(p=0.03)。两组间在Fugl-Meyer评定值上无显著差异。躯体感觉刺激可以改善中风后12个月内中重度偏瘫患者运动训练的客观结果，尽管这项研究中组间差异的大小需要确定它们是否与临床相关。未来的研究应该调查干预对这一人群的残疾和功能恢复的影响，以及潜在的干预效果的神经生理机制。
Determine whether somatosensory stimulation affects outcomes of motor training for moderate-to-severe upper extremity hemiparesis less than 12 months post-stroke. 55 adults participated in 18 intervention sessions pairing 2 hours of active (n=33) or sham (n=22) somatosensory stimulation with 4 hours of intensive task-oriented motor training. Wolf Motor Function Test, Action Research Arm Test, Fugl-Meyer Assessment, and Stroke Impact Scale were administered at baseline, post-intervention, and 1- and 4-month follow-up. Statistically significant between-groups differences favored the active condition on Wolf Motor Function Test at post (p=0.04) and Action Research Arm Test at post (p=0.02), 1-month (p=0.01), and 4-month (p=0.01) but favored the sham condition on Stroke Impact Scale at 1-month (p=0.03). There were no significant between-groups differences on Fugl-Meyer Assessment. Somatosensory stimulation can improve objective outcomes of motor training for moderate-to-severe hemiparesis less than 12 months after stroke, although the magnitude of between-groups differences in this study needs to be determined if they are clinically relevant. Future studies should investigate the intervention’s impact on disability and functional recovery for this population as well as neurophysiological mechanisms underlying intervention effects.