Early and repetitive stimulation of the arm can substantially improve the long-term outcome after stroke: A 5-year follow-up study of a randomized trial
Early and repetitive stimulation of the arm can substantially improve the long-term outcome after stroke: A 5-year follow-up study of a randomized trial
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DOI：
10.1161/01.str.0000121645.44752.f7
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发表时间：
2004-04-01
期刊：
影响因子：
8.3
通讯作者：
Cras, P
中科院分区：
文献类型：
--
作者：
Feys, H;De Weerdt, W;Cras, P
背景和目的：几项研究调查了中风急性期治疗干预对手臂的影响，随访时间最长为12个月。本研究的目的是检查中风后5年手臂重复性感觉运动训练的效果。研究对象和方法：100例连续中风患者被随机分配到实验组和对照组，实验组每天接受额外的手臂感觉运动刺激。干预期为6周。在干预前、干预中、干预后以及中风后6个月和12个月对患者进行评估。在这项研究中，62例患者在中风后5年重新评估。采用Brunnstrom-Fugl-Meyer （BFM）检验、Action Research Arm （ARA）检验和Barthel指数（BI）作为主要结局指标。结果-在5年的随访中，实验组的BFM和ARA测试结果均有统计学上的显著差异。从最初的评估到5年的评估，两组之间的平均改善差异对应于BFM的17分和ARA的17.4分。未发现对BI有影响。这种治疗对有严重初始运动缺陷的患者最为有效。结论：在中风后急性期对手臂进行特异性干预对运动功能有临床意义和持久的影响。这种效果可归因于早期、重复和有针对性的刺激。
Background and Purpose - Several studies have investigated the effect of therapeutic interventions for the arm in the acute phase after stroke, with follow-ups at a maximum of 12 months. The aim of this study was to examine the effect of repetitive sensorimotor training of the arm at 5 years after stroke.Subjects and Methods - One hundred consecutive stroke patients were randomly allocated either to an experimental group that received daily additional sensorimotor stimulation of the arm or to a control group. The intervention period was 6 weeks. Assessments of the patients were made before, midway, and after intervention, and at 6 and 12 months after stroke. In this study, 62 patients were reassessed at 5 years after stroke. The Brunnstrom-Fugl-Meyer (BFM) test, Action Research Arm (ARA) test, and Barthel index (BI) were used as the primary outcome measures.Results - At the 5-year follow-up, there was a statistically significant difference for both the BFM and ARA tests in favor of the experimental group. The mean differences in improvement between the groups from the initial evaluation to the 5-year assessment corresponded to 17 points on the BFM and 17.4 on the ARA. No effect was found for the BI. The treatment was most effective in patients with a severe initial motor deficit.Conclusions - Adding a specific intervention for the arm during the acute phase after a stroke resulted in a clinically meaningful and long-lasting effect on motor function. The effect can be attributed to early, repetitive, and targeted stimulation.