使用无动力装置对重度偏瘫患者进行双手训练:一项试点研究。

Preeti Raghavan, Viswanath Aluru, Sina Milani, Peter Thai, Daniel Geller, Seda Bilaloglu, Ying Lu, Donald J Weisz
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引用次数: 9

摘要

背景:对于中风后偏瘫患者,很少有训练手臂运动的方法。本研究的目的是测试使用无动力装置,双臂训练器(BAT)训练的安全性和可行性,以促进严重偏瘫患者的运动恢复。BAT使肩关节外旋的双手联合训练成为可能,这在严重中风后偏瘫患者中是可以减少的。双手训练的基本原理是利用对侧皮质活动来驱动几乎不能进行单手运动的患者受影响手臂的自主运动。方法:9例卒中后偏瘫患者,保留被动活动范围和修正Ashworth评分。结果:所有参与者均能耐受训练,无不良事件报告。参与者在训练后上肢Fugl-Meyer得分有显著改善,效应量为0.89。屈肌协同模式的改变占改善的64.7%。在训练和未训练的运动中,麻痹肢体的活动范围都有所改善。在训练后的沃尔夫运动功能测试中,一些参与者在执行选定任务所花费的时间上有所改善。结论:使用双手训练器促进重度偏瘫患者运动恢复的安全性和可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Coupled Bimanual Training Using a Non-Powered Device for Individuals with Severe Hemiparesis: A Pilot Study.

Background: Few options exist for training arm movements in participants with severe post-stroke hemiparesis who have little active range of motion. The purpose of this study was to test the safety and feasibility of training with a non-powered device, the Bimanual Arm Trainer (BAT), to facilitate motor recovery in individuals with severe hemiparesis. The BAT enabled coupled bimanual training of shoulder external rotation, which is reduced in individuals with severe post-stroke hemiplegia. The rationale for bimanual training was to harness contralesional cortical activity to drive voluntary movement in the affected arm in patients who could barely perform unimanual movements.

Methods: Nine participants with post-stroke hemiparesis, preserved passive range of motion and Modified Ashworth score of <3 in the shoulder and elbow joints, trained with the device for 45 minutes, twice a week for six weeks, and were assessed pre- and post-training.

Results: All participants tolerated the training and no adverse events were reported. Participants showed significant improvement in the upper extremity Fugl-Meyer score post-training with an effect size of 0.89. Changes in the flexor synergy pattern accounted for 64.7% of the improvement. Improvement in active range of motion in the paretic limb occurred for both trained and untrained movements. Some participants showed improvement in the time taken to perform selected tasks on the Wolf Motor Function Test post-training.

Conclusion: The results demonstrate the safety and feasibility of using the Bimanual Arm Trainer to facilitate motor recovery in individuals with severe hemiparesis.

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