Clinical Relevance of Action Observation in Upper-Limb Stroke Rehabilitation: A Possible Role in Recovery of Functional Dexterity. A Randomized Clinical Trial
Clinical Relevance of Action Observation in Upper-Limb Stroke Rehabilitation: A Possible Role in Recovery of Functional Dexterity. A Randomized Clinical Trial
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DOI：
10.1177/1545968311427406
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发表时间：
2012-06-01
影响因子：
4.2
通讯作者：
Sale, Patrizio
中科院分区：
文献类型：
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作者：
Franceschini, Marco;Ceravolo, Maria Gabriella;Sale, Patrizio
目标。一项随机对照观察者盲试验旨在评估动作观察作为中风后早期上肢功能标准康复的附加治疗的有效性。方法。中风幸存者（N = 102）在首次中风后30天（+/- 7）从13个中心连续招募，并随机分配到实验组（EG）或对照组（CG）。EG参与者观看了用上肢进行的日常任务（动作）的视频片段，以便准备模仿所呈现的动作。在每个序列的最后，治疗师会提示患者做同样的动作2分钟，并在需要时提供帮助。向计算机计算机显示没有动物或人类的静态图像。在每个序列结束时，CG执行模拟EG执行的肩关节和肘关节活动的动作。记录治疗前（T0）、治疗后4周（T1）、治疗结束后4 ~ 5个月（T2）随访时Fugl-Meyer测验、Frenchay臂测验、Box and Block测验（BBT）、改良Ashworth量表、功能独立测量运动项目的结果。结果。随着时间的推移，两种治疗方案对所有损伤和功能能力的测量都得到了改善。从BBT的广义估计方程分析中出现了时间与治疗的相互作用，显示了有利于EG的显著T0-T1和T0-T2差异。结论。这项多中心试验支持动作观察在上肢康复中的应用，以及镜像神经元系统在中风后恢复中的作用。
Objective. A randomized controlled observer-blind trial was designed to evaluate the effectiveness of action observation as an add-on treatment to the standard rehabilitation of upper-limb function, early after stroke. Methods. Stroke survivors (N = 102) were consecutively recruited from 13 centers 30 days (+/- 7) after a first-ever stroke and randomly assigned to the experimental (EG) or control group (CG). EG participants watched video footage of daily routine tasks (actions) carried out with the upper limb in order to prepare to imitate the presented action. At the end of each sequence, a therapist prompted the patient to perform the same movement for 2 minutes, providing help when needed. Static images without animals or human beings were shown to the CG. At the end of each sequence, the CG executed movements that simulated the shoulder and elbow joint mobilization activities performed by the EG. Results for the Fugl-Meyer test, Frenchay Arm test, Box and Block test (BBT), Modified Ashworth Scale, and Functional Independence Measure Motor items were recorded before treatment (T0), after 4 weeks of treatment (T1), and at the follow-up visit 4 to 5 months after the conclusion of treatment (T2). Results. An improvement over time was appreciated on all measures of impairment and functional ability with both treatment programs. A Time x Treatment interaction emerged from the generalized estimating equations analysis of BBT, showing significant T0-T1 and T0-T2 differences in favor of EG. Conclusion. This multicenter trial endorses the use of action observation in upper-extremity rehabilitation, along with a role for the mirror neuron system in poststroke recovery.