Mental practice in chronic stroke - Results of a randomized, placebo-controlled trial
Mental practice in chronic stroke - Results of a randomized, placebo-controlled trial
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DOI：
10.1161/01.str.0000260205.67348.2b
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发表时间：
2007-04-01
期刊：
影响因子：
8.3
通讯作者：
Leonard, Anthony
中科院分区：
文献类型：
--
作者：
Page, Stephen J.;Levine, Peter;Leonard, Anthony
背景和目的——一项特定运动技能的心理练习（MP）已经多次被证明能激活与该技能的身体练习相同的肌肉组织和神经区域。初步研究结果表明，在慢性中风患者中纳入MP的重要运动技能的康复计划提供了足够的重复练习，以增加受影响的手臂使用和功能。本二期研究采用随机对照方法和适当的样本量，比较了纳入特定手臂运动MP的康复方案与安慰剂条件下的疗效。方法：32例中度运动障碍的慢性脑卒中患者（平均3.6岁）接受30分钟的治疗，每周2天，持续6周，并强调日常生活活动。随机分配到实验条件的受试者也在治疗后直接接受30分钟的日常生活活动MP治疗；被分配到对照组的受试者接受与实验组相同数量的治疗师互动，并在治疗后直接进行假干预，包括放松。结果采用盲法评分，采用行动研究臂测试和Fugl-Meyer评估的上肢部分。结果：在任何人口统计学变量或运动量表上均未发现预先存在的群体差异。接受MP治疗的受试者显示受影响的手臂损伤显著减少，日常手臂功能显著增加（P < 0.0001水平）。只有接受MP治疗的患者表现出执行有价值活动的新能力。结论：研究结果支持心理练习对慢性脑卒中患者手臂运动功能的康复效果。这些变化具有临床意义。
Background and Purpose-Mental practice ( MP) of a particular motor skill has repeatedly been shown to activate the same musculature and neural areas as physical practice of the skill. Pilot study results suggest that a rehabilitation program incorporating MP of valued motor skills in chronic stroke patients provides sufficient repetitive practice to increase affected arm use and function. This Phase 2 study compared efficacy of a rehabilitation program incorporating MP of specific arm movements to a placebo condition using randomized controlled methods and an appropriate sample size.Method-Thirty-two chronic stroke patients ( mean = 3.6 years) with moderate motor deficits received 30-minute therapy sessions occurring 2 days/week for 6 weeks, and emphasizing activities of daily living. Subjects randomly assigned to the experimental condition also received 30-minute MP sessions provided directly after therapy requiring daily MP of the activities of daily living; subjects assigned to the control group received the same amount of therapist interaction as the experimental group, and a sham intervention directly after therapy, consisting of relaxation. Outcomes were evaluated by a blinded rater using the Action Research Arm test and the upper extremity section of the Fugl-Meyer Assessment.Results-No pre-existing group differences were found on any demographic variable or movement scale. Subjects receiving MP showed significant reductions in affected arm impairment and significant increases in daily arm function ( both at the P < 0.0001 level). Only patients in the group receiving MP exhibited new ability to perform valued activities.Conclusions-The results support the efficacy of programs incorporating mental practice for rehabilitating affected arm motor function in patients with chronic stroke. These changes are clinically significant.