Forced use after TBI: promoting plasticity and function through practice
Forced use after TBI: promoting plasticity and function through practice
复制标题
TBI后的强制使用：通过实践促进可塑性和功能
DOI：
10.1080/0269905031000107160
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发表时间：
2003
期刊：
影响因子：
1.9
通讯作者：
Stephen J. Page
中科院分区：
文献类型：
--
作者：
Stephen J. Page
目的：回顾支持改良约束诱导疗法（mCIT）改善创伤性脑损伤（TBI）患者上肢使用和功能的文献，并探讨其疗效。设计：多基线，前后，病例系列。单位：门诊。患者：3例1年前发生的TBI患者，表现为稳定的上肢偏瘫和习得性不使用。干预：患者参加10次，每次30分钟，有组织的物理和职业治疗，强调在有价值的功能性活动中使用更受影响的手臂，每周3次，持续10周，并使用整形技术。在相同的10周期间，他们的上肢受影响较小，每周5天，5小时内被确定为频繁使用的次数。主要观察指标：动作研究臂测试（ARA）、Wolf运动功能测试（WMFT）和运动活动日志（MAL）。结果：干预后，受试者在MAL测量的更多受影响肢体使用的数量和质量方面表现出bbb2.0的改善。受试者1、2和3在ARA上也表现出功能改善（分别为14.0、5.5和6.0），WMFT任务绩效评分改善（分别为1.15、1.7和1.35），执行所有WMFT任务所需的时间减少。结论：mCIT是一种很有前途的方法，可以改善创伤性脑损伤后的肢体使用和功能。
Objective : To review the literature supporting, and determine the efficacy of, modified constraint-induced therapy (mCIT) in improving more affected upper limb use and function in patients with traumatic brain injury (TBI). Design : Multiple-baseline, pre-post, case series. Setting : Outpatient clinic. Patients : Three patients with TBI occurring >1 year ago and exhibiting stable upper limb hemiparesis and learned non-use. Intervention : Patients participated in 10 sessions of 30 minute, structured physical and occupational therapy, emphasizing more affected arm use in valued, functional activities, three times/week for 10 weeks and using shaping techniques. Their less affected upper limbs were also restrained 5 days/week during 5 hours identified as times of frequent use during the same 10-week period. Main outcome measures : The Action Research Arm Test (ARA), Wolf Motor Function Test (WMFT) and Motor Activity Log (MAL). Results : Following intervention, subjects exhibited improvements > 2.0 in their amount and quality of more affected limb use, as measured by the MAL. Subjects 1, 2 and 3 also displayed functional improvements on the ARA (14.0, 5.5 and 6.0, respectively), improvements in ratings of WMFT task performance (1.15, 1.7 and 1.35, respectively) and diminished time needed to perform all WMFT tasks. Conclusions : mCIT is a promising approach by which improved more affected limb use and function can be realized following TBI.