Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke - A single-blind, randomized, controlled multicenter trial
Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke - A single-blind, randomized, controlled multicenter trial
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DOI：
10.1161/01.str.29.4.785
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发表时间：
1998-04-01
期刊：
影响因子：
8.3
通讯作者：
Van Hoydonck, GA
中科院分区：
文献类型：
--
作者：
Feys, HM;De Weerdt, WJ;Van Hoydonck, GA
背景和目的：众所周知，中风患者的手臂功能恢复很差。治疗方式的效果，特别是那些旨在改善上肢功能，主要是在慢性中风患者中进行了研究。本研究的目的是调查一个特定的治疗干预对手臂功能的影响，在急性期中风后。方法，在一个单盲，随机，对照多中心试验，100名连续患者被分配到一个实验组，接受额外的治疗感觉运动刺激或对照组。干预时间为6周。在干预前、干预中、干预后以及卒中后6个月和12个月随访时，对患者的损伤程度（Brunnstrom-Fugl-Meyer试验）和残疾程度（行动研究臂试验，Barthel指数）进行评估。结果在整个研究期间，实验组患者的Brunnstrom-Fugl-Meyer试验优于对照组，但仅在随访时差异有统计学意义。行动研究手臂测试和Barthel指数的结果显示，在残疾水平上没有效果。该疗法的效果归因于肌肉活动的重复刺激。治疗对有严重运动缺陷和偏盲或偏侧注意力不集中的患者最有效。没有不良影响，由于干预被发现。结论增加一个特定的干预在急性期中风后改善运动恢复，这是明显的1年后。这些结果强调了治疗干预对手臂的潜在有益作用。
Background and Purpose-Arm function recovery is notoriously poor in stroke patients. The effect of treatment modalities, particularly those directed at improving upper limb function, has been studied primarily in chronic stroke patients. The purpose of this study was to investigate the effect of a specific therapeutic intervention on arm function in the acute phase after stroke.Methods-In a single-blind, randomized, controlled multicenter trial, 100 consecutive patients were allocated to either an experimental group that received an additional treatment of sensorimotor stimulation or to a control group. The intervention was applied for 6 weeks. Patients were evaluated for level of impairment (Brunnstrom-Fugl-Meyer test) and disability (Action Research Arm test, Barthel Index) before, midway, and after the intervention period and at follow-up 6 and 12 months after stroke,Results-Patients in the experimental group performed better on the Brunnstrom-Fugl-Meyer test than those in the control group throughout the study period, but differences were significant only at follow-up. Results on the Action Research Arm test and Barthel Index revealed no effect at the level of disability. The effect of the therapy was attributed to the repetitive stimulation of muscle activity. The treatment was most effective in patients with a severe motor deficit and hemianopia or hemi-inattention. No adverse effects due to the intervention were found.Conclusions-Adding a specific intervention during the acute phase after stroke improved motor recovery, which was apparent 1 year later. These results emphasize the potential beneficial effect of therapeutic interventions for the arm.