Repetitive bilateral arm training and motor cortex activation in chronic stroke - A randomized controlled trial
Repetitive bilateral arm training and motor cortex activation in chronic stroke - A randomized controlled trial
复制标题
DOI：
10.1001/jama.292.15.1853
复制
发表时间：
2004-10-20
影响因子：
120.7
通讯作者：
Hanley, DF
中科院分区：
文献类型：
--
作者：
Luft, AR;McCombe-Waller, S;Hanley, DF
脑卒中偏瘫早期恢复过程中发生中枢运动网络的重组。在慢性脑卒中幸存者中，特定的康复治疗可以改善上肢功能。目的验证以下假设：在脑卒中后有慢性运动障碍的患者中，改善手臂功能的特定康复治疗与皮质网络的重组有关。设计、设置和患者在美国门诊康复计划中对21例患者进行随机对照临床试验（单侧卒中后中位数[IQR]为50.3 [34.8-77.3]个月）。研究资料收集于2001年至2004年。干预方法患者被随机分配至双侧手臂节律性听觉提示训练组（BATRAC）（n=9）和标准化剂量匹配治疗运动组（DMTE）（n=12）。两组均进行1小时，每周3次，共6 wheels.Main结果测量干预前后2周内，通过功能性磁共振成像（fMRI）评估肘关节运动期间的大脑激活，并使用手臂功能评分评估功能结果。在对侧大脑和同侧小脑中观察到激活的变化（P=.009）。BATRAC与中央前区激活显著增加相关（P
Context Reorganization in central motor networks occurs during early recovery from hemiparetic stroke. In chronic stroke survivors, specific rehabilitation therapy can improve upper extremity function.Objective To test the hypothesis that in patients who have chronic motor impairment following stroke, specific rehabilitation therapy that improves arm function is associated with reorganization of cortical networks.Design, Setting, and Patients A randomized controlled clinical trial conducted in a US ambulatory rehabilitation program with 21 patients (median [IQR], 50.3 [34.8-77.3] months after unilateral stroke). Data were collected between 2001 and 2004.Interventions Patients were randomly assigned to bilateral arm training with rhythmic auditory cueing (BATRAC) (n=9) or standardized dose-matched therapeutic exercises (DMTE) (n=12). Both were conducted for 1 hour, 3 times a week, for 6 weeks.Main Outcome Measures Within 2 weeks before and after the intervention, brain activation during elbow movement assessed by functional magnetic resonance imaging (fMRI) and functional outcome assessed using arm function scores.Results Patients in the BATRAC group but not in the DMTE group increased hemispheric activation during paretic arm movement (P=.03). Changes in activation were observed in the contralesional cerebrum and ipsilesional cerebellum (P=.009). BATRAC was associated with significant increases in activation in precentral (P