SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation: A Randomized Controlled Trial
SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation: A Randomized Controlled Trial
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DOI：
10.1177/1545968310397705
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发表时间：
2011-05-01
影响因子：
4.2
通讯作者：
Matyas, Thomas A.
中科院分区：
文献类型：
--
作者：
Carey, Leeanne;Macdonell, Richard;Matyas, Thomas A.
背景资料。感觉丧失是中风后的常见症状，对周围环境的探索、手的功能和日常活动的恢复都有负面影响。目标。比较基于知觉学习的感觉辨别程序与通过被动运动和抓取常见物体而非特定地暴露于感觉刺激的效果。方法：研究方法。作者进行了一项随机、平行分组对照试验，受试者、临床评估员和数据分析员均为盲人。50名纹理辨别、肢体位置感觉和/或触觉物体识别受损(中风后6周，中位数48周)的受试者被随机分成两组，分别接受躯体感觉辨别训练(n=25)或重复暴露于感觉刺激(n=25)，每次训练时间为60分钟，总计10小时。主要结果是干预后综合标准化躯体感觉障碍(SSD)指数的变化。分别于训练后6周和6个月进行随访。结果。组间比较显示，感觉辨别训练后感觉能力有显著改善，t(47)=2.75，P=.004，单尾；组间平均变化=11.1SSD；可信区间3.0至19.2。改善维持在6周和6个月。结论。感觉辨别训练可显著提高卒中后功能性感觉辨别能力。临床定向训练实现了训练效果向新刺激的转移。我们的研究结果为在卒中后感觉障碍的康复中引入感觉辨别训练提供了支持。
Background. Sensory loss is common after stroke, with negative impact on exploration of the immediate environment, hand function, and return to daily activities. Objective. To compare the effectiveness of a perceptual-learning based sensory discrimination program versus non-specific exposure to sensory stimuli via passive movements and grasping of common objects. Methods. The authors conducted a randomized parallel-group controlled trial, with blinding of subjects, clinical assessors, and data analysts. Fifty subjects with impaired texture discrimination, limb position sense, and/or tactile object recognition (>6 weeks, median 48 weeks poststroke) were randomized to receive somatosensory discrimination training (n = 25) or repeated exposure to sensory stimuli (n = 25) in 60-minute sessions for a total of 10 hours. The primary outcome was change in a composite standardized somatosensory deficit (SSD) index following intervention. Follow-up was at 6 weeks and 6 months posttraining. Results. Between-group comparisons revealed a significantly greater improvement in sensory capacity following sensory discrimination training, t(47) = 2.75, P = .004, 1-tailed; mean between-group change = 11.1 SSD; confidence interval 3.0 to 19.2. Improvements were maintained at 6 weeks and 6 months. Conclusion. Sensory discrimination training can achieve significant improvements in functional sensory discrimination capacity after stroke. The clinically oriented training achieved transfer of training effects to novel stimuli. Our findings provide support for introducing SENSe discrimination training in rehabilitation of sensory deficits after stroke.