A study of constraint-induced movement therapy in subacute stroke patients in Hong Kong
A study of constraint-induced movement therapy in subacute stroke patients in Hong Kong
复制标题
香港亚急性中风患者的约束诱导运动疗法研究
作者：
J. Myint;Grace Yuen;T. Yu;C. Kng;A. Wong;K. C. Chow;Hercy Chi Kong Li;C. P. Wong
目的：探讨强迫诱导运动疗法对改善早期亚急性脑卒中偏瘫患者上肢功能的有益作用。设计：一项前瞻性、单盲、随机对照研究，比较干预后和12周随访时强制诱导运动疗法或对照疗法的有效性。对象：纳入标准为卒中后2~16周，患肢偏瘫，≥最小功能伸腕20度，≥伸指10度，≥评分17分。干预：干预组接受为期10天的上肢训练(每天4h)，健侧肢体用肩带固定，对照组接受同等时间的常规康复治疗。主要测量：偏瘫患者上肢功能水平、运动活动日志、动作研究性手臂测试和改良Barthel指数。结果：强迫诱导运动疗法组23例，对照组20例。在干预后和强制诱导运动治疗后12周，偏瘫上肢的功能水平(P=0.001)以及运动活动日志的“使用量”(P=0.001)和“如何良好”(P=0.021)子量表均有显著改善。干预后动作研究性手臂测试总分、握力(P=0.004)、握力(P=0.004)、握力(P=0.032)和粗大(P=0.006)成分均较对照组有显著改善。12周时握力部分(P=0.019)和动作研究手臂测试总分(P=0.009)均优于对照组。结论：强迫诱导运动疗法能明显改善亚急性期卒中患者的手功能，并可维持至12周随访。
Objective: To investigate the beneficial effect of constraint-induced movement therapy in improving the function of hemiplegic upper extremity in the early subacute stroke patients. Design: A prospective, single-blinded, randomized controlled study comparing the effectiveness of constraint-induced movement therapy or control treatment at post intervention and 12 weeks follow-up. Subjects: The inclusion criteria were 2—16 weeks after stroke, hemiparesis of the affected limb, minimal function of ≥20 degrees wrist extension and ≥10 degrees extension of all digits and Mini-Mental State Examination score ≥17. Interventions: The intervention group underwent a programme of 10 days upper extremity training (4 hours per day) with the unaffected limb being restrained in a shoulder sling and the control group received an equivalent duration of conventional rehabilitation therapy. Main measures: Functional level for hemiparetic upper extremity, Motor Activity Log, Action Research Arm Test and modified Barthel Index. Results: There were 23 and 20 subjects respectively in the constraint-induced movement therapy and control groups. Significant improvements were seen at post intervention and 12 weeks after constraint-induced movement therapy in functional level for hemiparetic upper extremity (P= 0.001), and in the `amount of use' (P= 0.001) and `how well' (P= 0.021) subscales of the Motor Activity Log. The total Action Research Arm Test score, grasp (P= 0.004), grip (P= 0.004), pinch (P= 0.032) and gross (P= 0.006) components showed significant improvement over the control group at post intervention. The grip component (P=0.019) and the total Action Research Arm Test score (P= 0.009) were superior to the control group at 12 weeks. Conclusion: Significant improvement in hand function could be achieved with constraint-induced movement therapy in subacute stroke patients, which was maintained up to 12 week follow-up.
DOI：
10.1016/j.apmr.2005.01.010
发表时间：
2005-07-01
影响因子：
4.3
作者：
Uswatte, G;Foo, WL;Simms, LB
通讯作者：
Simms, LB
影响因子：
2.5
作者：
Kleim, JA;Barbay, S;Nudo, RJ
通讯作者：
Nudo, RJ
影响因子：
120.7
作者：
Wolf, Steven L.;Winstein, Carolee J.;Nichols-Larsen, Deborah
通讯作者：
Nichols-Larsen, Deborah