Constraint induced movement therapy in subacute stroke

描述(由申请人提供)：具体目标： 1.评估强迫诱导运动疗法治疗两周的效果 (CIMT)结合偏瘫上肢行为训练对运动康复的影响 首次在卒中后14天内接受治疗的缺血性或出血性中风患者。 2.利用经颅磁图研究大脑皮质运动表征的重组 偏瘫患者CIMT加行为训练两周后的刺激(TMS) 在发病后14天内开始治疗的患者的上肢 出血性中风。 3.采用经颅磁刺激，研究脑功能改变与脑功能改变之间的关系 患侧上肢皮质表现及运动功能改善 在发生缺血性或出血性中风后14天内接受治疗的患者。 假设： 1.CIMT每日给药两周，同时对患侧上肢进行行为训练 相对于同等数量的传统疗法，肢体有助于运动恢复 在缺血性或出血性中风后第14天开始治疗的患者。 2.CIMT结合患侧上肢行为训练，每日2次 卒中后第14天开始的几周将增加受影响的皮质代表 TMS测量的手。 3.患侧上肢运动功能的改善与治疗后有关 TMS的皮质表现增加。

DESCRIPTION (provided by the applicant): SPECIFIC AIMS: 1. Evaluate the effects of two weeks of treatment with Constraint Induced Movement therapy (CIMT) combined with behavioral training of the paretic upper limb on motor recovery in patients with ischemic or hemorrhagic stroke who are initially treated within 14 days poststroke. 2. Investigate reorganization of cortical motor representation using transcranial magnetic stimulation (TMS) after two weeks of combined CIMT and behavioral training of the paretic upper limb in patients who begin treatment within 14 days after onset of ischemic or hemorrhagic stroke. 3. Using transcranial magnetic stimulation, investigate the relationship between changes in cortical representation and improvement in motor function of the affected upper limb in patients treated within 14 days after sustaining ischemic or hemorrhagic stroke. HYPOTHESES: 1. CIMT given daily for two weeks concomitant with behavioral training of the affected upper limb facilitates motor recovery relative to an equal number of sessions of traditional therapy in patients who are initially treated by day 14 after ischemic or hemorrhagic stroke. 2. Combined CIMT and behavioral training of the affected upper limb administered daily for 2 weeks beginning by day 14 post-stroke will increase cortical representation of the affected hand as measured by TMS. 3. Improved motor function of the affected upper limb will be related to the post treatment increase in cortical representation on TMS.