Benefits of a Repetitive Facilitative Exercise Program for the Upper Paretic Extremity After Subacute Stroke: A Randomized Controlled Trial
Benefits of a Repetitive Facilitative Exercise Program for the Upper Paretic Extremity After Subacute Stroke: A Randomized Controlled Trial
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DOI：
10.1177/1545968312465896
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发表时间：
2013-05-01
影响因子：
4.2
通讯作者：
Kawahira, Kazumi
中科院分区：
文献类型：
--
作者：
Shimodozono, Megumi;Noma, Tomokazu;Kawahira, Kazumi
背景重复易化运动（RFE）是近年来发展起来的一种高重复率和神经易化相结合的脑卒中肢体功能康复方法。初步调查令人鼓舞，但尚未进行随机对照评价。目标.比较RFE与常规康复治疗对亚急性脑卒中成人患者的疗效。方法.共有52名持续时间为3 - 13周的卒中相关上肢损伤（Brunnstrom分期≥ III）成人参与了这项随机、对照、双盲试验。将受试者随机分为2组，接受4周，40 min/d，5 d/wk的治疗方案。被分配到RFE的患者接受了100个标准化运动，至少有5个关节的患上肢，而对照组的患者参加了传统的上肢康复计划。在训练结束时评估主要和次要结局（分别为团体行动研究手臂测试[ARAT]和Fugl-Meyer手臂[FMA]评分的改善）。结果共有49名受试者（26名接受RFE）完成了试验。基线时ARAT和FMA评分分别为19 +/- 21和39 +/- 21（平均值+/-标准差）。试验结束时的评估显示，RFE组在ARAT（F = 7.52; P = 0.009）和FMA（F = 5.98; P = 0.019）评分方面的改善明显大于对照组。结论.这些结果表明，RFE可能比常规康复更有效地减轻脑卒中亚急性期的损伤，改善上肢运动功能。
Background. Repetitive facilitative exercise (RFE), a combination of high repetition rate and neurofacilitation, is a recently developed approach to the rehabilitation of stroke-related limb impairment. Preliminary investigations have been encouraging, but a randomized controlled evaluation has yet to be performed. Objectives. To compare the efficacy of RFE with that of conventional rehabilitation in adults with subacute stroke. Methods. A total of 52 adults with stroke-related upper-limb impairment (Brunnstrom stage >= III) of 3 to 13 weeks' duration participated in this randomized, controlled, observer-blinded trial. Participants were randomized into 2 groups and received treatment on a 4-week, 40 min/d, 5 d/wk schedule. Those assigned to RFE received 100 standardized movements of at least 5 joints of their affected upper extremity, whereas those in the control group participated in a conventional upper-extremity rehabilitation program. Primary and secondary outcomes (improvement in group Action Research Arm Test [ARAT] and Fugl-Meyer Arm [FMA] scores, respectively) were assessed at the end of training. Results. In all, 49 participants (26 receiving RFE) completed the trial. ARAT and FMA scores at baseline were 19 +/- 21 and 39 +/- 21 (mean +/- standard deviation). Evaluation at the trial's completion revealed significantly larger improvements in the RFE group than in the control group in both ARAT (F = 7.52; P = .009) and FMA (F = 5.98; P = .019) scores. Conclusions. These findings suggest that RFE may be more effective than conventional rehabilitation in lessening impairment and improving upper-limb motor function during the subacute phase of stroke.