Cerebellar Ataxia Rehabilitation Trial in Degenerative Cerebellar Diseases
Cerebellar Ataxia Rehabilitation Trial in Degenerative Cerebellar Diseases
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DOI：
10.1177/1545968311425918
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发表时间：
2012-06-01
影响因子：
4.2
通讯作者：
Nishizawa, Masatoyo
中科院分区：
文献类型：
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作者：
Miyai, Ichiro;Ito, Mizuki;Nishizawa, Masatoyo
Objective.研究强化康复治疗对退行性小脑疾病患者共济失调、步态和日常生活能力（ADL）的短期和长期影响。方法.共有42例单纯小脑变性患者被随机分配到即时组或延迟进入对照组。直接组接受2小时的住院物理和职业治疗，重点是协调，平衡和ADL，在工作日和周末1小时，为期4周。对照组在延迟4周后接受相同的干预。比较即刻组和对照组的短期结果。在干预后4、12和24周对两组进行长期评估。结果测量包括共济失调的评估和评级、功能独立性测量、步态速度、步频、功能性步行分类和福尔斯次数。结果即刻组在共济失调、步态速度和ADL方面的功能改善显著高于对照组。躯干共济失调的改善比肢体共济失调更显著。共济失调和步态的改善分别在12周和24周时持续。22例患者在24周时至少有1项指标优于基线。结论.强化康复的短期效益在退行性小脑疾病患者中是明显的。虽然功能状态在24周内趋于下降到基线水平，但超过一半的参与者保持了增益。
Objective. To investigate short- and long-term effects of intensive rehabilitation on ataxia, gait, and activities of daily living (ADLs) in patients with degenerative cerebellar disease. Methods. A total of 42 patients with pure cerebellar degeneration were randomly assigned to the immediate group or the delayed-entry control group. The immediate group received 2 hours of inpatient physical and occupational therapy, focusing on coordination, balance, and ADLs, on weekdays and 1 hour on weekends for 4 weeks. The control group received the same intervention after a 4-week delay. Short-term outcome was compared between the immediate and control groups. Long-term evaluation was done in both groups at 4, 12, and 24 weeks after the intervention. Outcome measures included the assessment and rating of ataxia, Functional Independence Measure, gait speed, cadence, functional ambulation category, and number of falls. Results. The immediate group showed significantly greater functional gains in ataxia, gait speed, and ADLs than the control group. Improvement of truncal ataxia was more prominent than limb ataxia. The gains in ataxia and gait were sustained at 12 weeks and 24 weeks, respectively. At least 1 measure was better than at baseline at 24 weeks in 22 patients. Conclusions. Short-term benefit of intensive rehabilitation was evident in patients with degenerative cerebellar diseases. Although functional status tended to decline to the baseline level within 24 weeks, gains were maintained in more than half of the participants.