Continuous passive motion improves shoulder joint integrity following stroke
Continuous passive motion improves shoulder joint integrity following stroke
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DOI：
10.1191/0269215505cr901oa
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发表时间：
2005-09-01
影响因子：
3
通讯作者：
Volpe, BT
中科院分区：
文献类型：
--
作者：
Lynch, D;Ferraro, M;Volpe, BT
目的：在一项针对首次中风和偏瘫患者的初步研究中，我们试图确定用持续被动运动（CPM）治疗上肢是否会改变损伤、残疾或相关的不良症状，如肩关节不稳定、疼痛和张力。设计：患者被随机分配接受每日CPM治疗或在职业治疗师的监督下参加自我活动范围组。所有患者每天接受标准的中风后治疗3.5小时。入院和出院时，一名盲法评估员使用标准化的损伤、残疾和不良症状量表对患者进行评估。环境：急性康复医院中风专科病房。受试者：连续筛选280例患者，其中35例首次单侧中风，急性事件发生后13 +/- 6天，提供知情同意，并随机分配到CPM治疗或监督组自我范围运动。主要测量：32人完成了研究，并使用运动损伤（Fugl-Meyer，运动状态量表和医学研究委员会运动功率），不良症状（关节-肱骨稳定性，疼痛和张力）和残疾（功能独立性测量）的标准化测量进行评估。结果：与进行治疗师监督的自我活动范围的患者相比，cpm治疗的患者在改善肩关节稳定性方面表现出积极的趋势（p = 0.06，置信区间- 0.03,2.3）。在运动障碍、残疾、疼痛或张力方面没有显著差异。结论：与传统的自我活动范围运动相比，装置提供的持续被动活动范围可能对中风后偏瘫手臂的一些不良症状减轻有更大的好处。
Objective: In a pilot study of patients with a first stroke and hemiparesis, we sought to determine whether treatment of the upper limb with continuous passive motion (CPM) that was device delivered would alter impairment, disability or the associated adverse symptoms of shoulder joint instability, pain and tone.Design: Patients were randomly assigned to receive daily CPM treatments or participate in self-range of motion groups under the supervision of an occupational therapist. All patients received standard daily poststroke therapy for 3.5 h per day. A blinded evaluator at admission and discharge assessed patients using standardized scales of impairment, disability and adverse symptoms.Setting: Specialized stroke unit of an acute rehabilitation hospital.Subjects: Two hundred and eighty consecutive patients were screened and 35 of these with a first unilateral stroke, 13 +/- 6 days following the acute event, provided informed consent and were randomly assigned to CPM treatment or supervised group self-range exercise.Main measures: Thirty-two completed the study and were evaluated using standardized measures for motor impairment (Fugl-Meyer, Motor Status Scale and Medical Research Council Motor Power), adverse symptoms (gleno-humeral stability, pain and tone), and disability ( Functional Independence Measure).Results: CPM-treated patients demonstrated positive trends towards improved shoulder joint stability ( p = 0.06, confidence interval - 0.03, 2.3) when compared with patients performing therapist-supervised self-range of motion. There were no significant differences in motor impairment, disability, pain or tone.Conclusions: Device-delivered continuous passive range of motion may offer an enhanced benefit for some adverse symptom reduction in the hemiplegic arm after stroke over traditional self-range of motion exercise.