REPETITIVE TRAINING OF ISOLATED MOVEMENTS IMPROVES THE OUTCOME OF MOTOR REHABILITATION OF THE CENTRALLY PARETIC HAND
REPETITIVE TRAINING OF ISOLATED MOVEMENTS IMPROVES THE OUTCOME OF MOTOR REHABILITATION OF THE CENTRALLY PARETIC HAND
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DOI：
10.1016/0022-510x(95)00003-k
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发表时间：
1995-05-01
影响因子：
4.4
通讯作者：
MAURITZ, KH
中科院分区：
文献类型：
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作者：
BUTEFISCH, C;HUMMELSHEIM, H;MAURITZ, KH
标准化训练对患手运动的影响已在27例轻偏瘫患者中进行了研究，采用多基线方法。训练包括重复的手和手指屈曲和伸展对各种负荷，每天进行两次，每次15分钟。握力（p < 0.006）、等张手伸展的峰值力（p < 0.05）、等张手伸展的峰值加速度（p < 0.05）以及收缩速度作为运动表现的指标在训练期间显著改善。与手部和手指运动的标准化训练相反，Bobath概念的治疗策略旨在降低增强的肌张力，而不直接加强中枢性麻痹远端肌群的活动。单独接受这种治疗方法的患者手部运动能力没有显著改善。因此，本研究的结果强调了频繁重复运动对中枢性麻痹手部运动康复的重要性，并挑战了传统的物理治疗策略，即专注于减少痉挛，而不是早期开始主动运动。
The effect of a standardized training on movements of the affected hand has been studied in 27 hemiparetic patients using a multiple baseline approach across individuals. The training consisted of repetitive hand and finger flexions and extensions against various loads and was carried out twice daily during 15-min periods. Grip strength (p < 0.006), peak force of isometric hand extensions (p < 0.05), peak acceleration (p < 0.05) of isotonic hand extensions as well as contraction velocities as indicators of motor performance significantly improved during the training period. In contrast to the standardized training of hand and finger movements, therapeutic strategies following the Bobath concept aim at reducing enhanced muscle tone without reinforcing the activity in centrally paretic distal muscle groups directly. Patients undergoing this treatment approach alone did not experience a significant improvement in the motor capacity of the hand. Therefore, the results of the present study emphasize the importance of frequent movement repetition for the motor rehabilitation of the centrally paretic hand and challenge conventional physiotherapeutic strategies that focus on spasticity reduction instead of early initiation of active movements.