Comparison of Bilateral and Unilateral Training for Upper Extremity Hemiparesis in Stroke
Comparison of Bilateral and Unilateral Training for Upper Extremity Hemiparesis in Stroke
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DOI：
10.1177/1545968309338190
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发表时间：
2009-11-01
影响因子：
4.2
通讯作者：
Corcos, Daniel M.
中科院分区：
文献类型：
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作者：
Stoykov, Mary Ellen;Lewis, Gwyn N.;Corcos, Daniel M.
背景上肢轻偏瘫是中风后最常见的残疾。纵向研究表明，30%至66%的中风幸存者在中风后6个月没有完全的手臂功能。一种有希望的治疗方法是双边培训。到目前为止，尚未在中度上肢损伤的慢性卒中幸存者中进行比较2组（双侧训练vs单侧训练）使用类似任务的疗效的随机、设盲研究。objective.比较双侧训练与单侧训练对中度上肢轻偏瘫患者的有效性。作者假设，双侧训练在近端优于单侧训练，但在远端则不然。方法. 24名受试者参加了一项随机、单盲培训研究。双侧组（n = 12）的受试者进行双侧对称活动，而单侧组（n = 12）仅用患臂进行相同的活动。这些活动包括有节奏和离散的基于到达的任务。运动评估量表（MAS），运动状态量表（MSS）和肌肉力量被用作结果指标。由对分组不知情的评估者在基线和培训后进行评估。结果两组的MSS和力量指标都有显著改善。双侧组在上臂功能量表（MAS-上肢项目的子量表）上有显著更大的改善。结论双侧和单侧训练对中度受损的慢性卒中幸存者都有效。双侧训练可能对近端手臂功能更有利。
Background. Upper extremity hemiparesis is the most common poststroke disability. Longitudinal studies have indicated that 30% to 66% of stroke survivors do not have full arm function 6 months poststroke. One promising treatment approach is bilateral training. To date, no randomized, blinded study of efficacy comparing 2 groups (bilateral training vs unilateral training) using analogous tasks has been performed in chronic stroke survivors with moderate upper extremity impairment. Objective. To compare the effectiveness of bilateral training with unilateral training for individuals with moderate upper limb hemiparesis. The authors hypothesized that bilateral training would be Superior to unilateral training in the proximal extremity but not the distal one. Methods. Twenty-four subjects participated in a randomized, single-blind training study. Subjects in the bilateral group (n = 12) practiced bilateral symmetrical activities, whereas the unilateral group (n = 12) performed the same activity with the affected arm only. The activities consisted of reaching-based tasks that were both rhythmic and discrete. The Motor Assessment Scale (MAS), Motor Status Scale (MSS), and muscle strength were used as outcome measures. Assessments were administered at baseline and posttraining by a rater blinded to group assignment. Results. Both groups had significant improvements on the MSS and measures of strength. The bilateral group had significantly greater improvement on the Upper Arm Function scale (a subscale of the MAS-Upper Limb Items). Conclusion. Both bilateral and unilateral training are efficacious for moderately impaired chronic stroke survivors. Bilateral training may be more advantageous for proximal arm function.