A TREATMENT FOR EXCESS MOTOR DISABILITY IN THE AGED

老年人过度运动障碍的治疗

• 批准号: 2838824
• 负责人: Edward Taub
• 金额: $ 30.16万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-12-09 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2838824
• 关键词: age difference; aging; behavioral /social science research tag; clinical research; functional ability; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; immobilization of body part; limb movement; magnetic resonance imaging; outcomes research; person with disability; physical therapy; rehabilitation; restraint; stroke

In this laboratory we have developed a new set of techniques that preliminary studies suggest can substantially reduce the incapacitating motor deficit of many elderly stroke patients and lessen their dependence. The techniques involve "constraint-induced" (CI) facilitation of impaired movement and include prolonged motor restriction of the unaffected upper extremity by a sling while at the same time training the affected upper limb. Initial results indicate that old age, per se, is not an important factor in limiting the final level of motor recovery attainable. Limitations of the work previously carried out in this laboratory were the small sample size and a control intervention that was not equal in credibility to the experimental intervention. Aim 1 of the proposed research will be to address these two issues. The sample size will be increased. In addition, the interventions employed in two physical therapy comparison groups have been redesigned so that they will be equal in credibility to that employed with the CI group. Aim 2 of the project is to determine whether aging is a factor in the speed or extent to which the motor impairment of the upper extremity in chronic stroke patients can be reduced by CI techniques. Aim 3 of the study is to ascertain through the use of magnetic resonance imaging whether there is some commonality in the location or extent of the lesions that characterize patients who benefit most from use of CI techniques. The goal of Aim 4 is to assess in a controlled study whether either the intensive or conventional physical therapy we propose to employ is effective in improving the upper extremity motor status of chronic stroke patients. The research team is interdisciplinary and includes three psychologists (with the emphasis of different individuals being in rehabilitation and motor control, statistics and gerontology), a neurologist and two physical therapists. The experimental design will involve 80 subjects randomly assigned to four groups (with blocking based on age). One group will receive movement restriction of the impaired upper extremity for a period of two weeks and training of the unaffected upper extremity. These results will be compared with those of a group of subjects receiving intensive physical therapy, a group of subjects receiving conventional physical therapy and a group of subjects on a waiting list. Each group of 20 will have equal numbers of persons with left - and right - brain strokes. The motor function, amount of limb use and range of motion of these individuals will be assessed before and after intervention and during followup, both in the laboratory and in the life situation.

在这个实验室里，我们开发了一套新的技术， 初步研究表明， 失能 许多老年中风患者的运动缺陷，并减少他们的 依赖 这些技术涉及“约束诱导”（CI） 促进受损的运动，包括延长运动 限制 用吊带吊住未受影响的上肢， 训练受影响的上肢 初步结果表明， 老年， 本身并不是限制最终水平的重要因素， 电机 可实现的恢复。 以前开展的工作的局限性 于 这个实验室是小样本量和控制 干预 这在可信度上与实验干预不相等。 目的 1的拟议研究将解决这两个问题。 的 样本量将增加。 此外，干预措施 采用 在两个物理治疗比较组中，已经重新设计， 的 它们的可信度将与CI所采用的相同 组 该项目的目标2是确定老化是否是一个因素， 的 上肢运动障碍的速度或程度 下肢 慢性脑卒中患者可以通过CI技术来减少。 目标3 的 研究是通过使用磁共振成像来确定 是否有一些共同的位置或程度， 从使用CI中获益最多的患者的特征性病变 技术. 目标4的目标是在对照研究中评估 是否 无论是密集的或传统的物理治疗，我们建议， 结论：采用运动疗法能有效改善上肢运动功能 的 慢性中风患者 研究团队是跨学科的 和 包括三位心理学家（强调不同的 个人 在康复和运动控制，统计和 老年学）， 一名神经科医生和两名理疗师 实验设计 将 将80名受试者随机分为4组（区组 基于 年龄）。 其中一组将受到 受损 上肢为期两周的时间和训练的 影响 上肢的 这些结果将与一个 组 接受强化物理治疗的受试者，一组受试者 接受传统的物理治疗和一组受试者 一 等候名单 每20人一组， 与 左右脑中风 运动功能，数量 肢体使用 这些人的活动范围将在 和 干预后和随访期间，无论是在实验室和 在 生活状况。