Effects of purposeful action observation on kinematic patterns of upper extremity in individuals with hemiplegia

[Purpose] This study investigated the effects of purposeful action observation on upper extremity kinematic patterns in individuals with hemiplegia. [Subjects and Methods] Twelve patients were recruited in accordance with the inclusion criteria. The experimental group (n=6) was trained with a purposeful action observation program. The control group (n=6) was trained with only purposeful action without action observation. The programs were performed 30 min/session, 5 times per week for 30 sessions in 6 weeks of training. Upper extremity kinematic patterns were measured by a 3-dimensional motion analysis system before and after training, and the results were analyzed. [Results] The experimental group and the control group showed improvements in average velocity, trajectory ratio, and movement degree, but no statistically significant differences were observed between the groups. The experimental group showed statistically significant improvements in average velocity, trajectory ratio after the intervention. The experimental group also showed an improvement in movement degree, but the post-intervention difference was not significant. [Conclusion] The results of this study show that purposeful action observation training program improved the average velocity and trajectory ratio of stroke patients. Further research should enroll more subjects divided into more specific groups for treatment.Key words: Action observation, Kinematic patterns, Stroke     

动作观察配合作业治疗对脑卒中患者上肢功能及日常生活能力的影响

目的 探讨动作观察配合作业治疗对脑卒中患者上肢功能及日常生活能力的影响。 方法 将42例脑卒中偏瘫患者按照随机数字表法分为实验组和对照组,每组21例。所有患者均接受常规康复治疗,实验组在此基础上增加动作观察配合作业治疗,对照组增加常规作业治疗。在治疗前和治疗8周后（治疗后）,采用Fugl-Meyer运动功能量表上肢部分（FMA-UE）、香港版偏瘫上肢功能测试（FTHUE-HK）和改良Barthel指数（MBI）评价患者的上肢运动功能和日常生活能力。 结果 治疗前,2组患者FMA-UE、FTHUE-HK、MBI结果比较,差异无统计学意义（P>0.05）。与组内治疗前比较,2组患者FMA-UE、FTHUE-HK、MBI均有所改善（P<0.05）。与对照组治疗后比较,实验组FMA-UE［（42.81±13.59）分］、FTHUE-HK［（5.00±1.38）级］、MBI［（73.86±18.83）分］较为优异（P<0.05）。 结论 动作观察配合作业治疗能更好地改善脑卒中患者的上肢功能及日常生活能力。     

Effect of mirror therapy with tDCS on functional recovery of the upper extremity of stroke patients

[Purpose] This study aimed to determine the effect of mirror therapy (MT) with transcranial direct current stimulation (tDCS) on the recovery of the upper extremity function of chronic stroke patients. [Subjects] Twenty-seven patients at least 6 months after stroke onset were divided randomly into an experimental group (14 patients) and a control group (13 patients). [Methods] All subjects received tDCS for 20 min followed by a 5 min rest. Then the experimental group received MT while the control group conducted the same exercises as the experimental group using a mirror that did not show the non-paretic upper extremity. The groups performed the same exercises for 20 min. All subjects received this intervention for 45-min three times a week for 6 weeks. [Results] After the intervention, the experimental group showed significant improvements in the box and block test (BBT), grip strength, and the Fugl-Meyer assessment (FMA), and a significant decrease in the Jebsen-Taylor test. The control group showed a significant increase in grip strength after the intervention, and a significant decrease in the Jebsen-Taylor test. Comparison of the result after the intervention revealed that the experimental group showed more significant increases in the BBT and grip strength than the control group. [Conclusion] These results show that MT with tDCS has a positive effect on the functional recovery of the upper extremity of stroke patients, through activating motor regions in the brain, and thus plays an important role in recovery of neuroplasticity.Key words: tDCS, Mirror therapy, Stroke     

Effects of mental practice on stroke patients’ upper extremity function and daily activity performance

[Purpose] The purpose of this study was to evaluate the effects of mental practice on stroke patients’ upper extremity function and activities of daily living (ADL). [Subjects and Methods] In this study, 29 stroke patients were randomly assigned to two groups: an experimental group (n=14) and a control group (n=15). The experimental group performed 10 minutes of mental practice once a day, 5 days a week for 2 weeks in combination with conventional rehabilitation therapy. For the control group, general rehabilitation therapy was provided during the same sessions as the experimental group. The Action Research Arm Test (ARAT) and the Fugl-Myer assessment (FMA) were used to measure upper extremity function, and the Modified Bathel Index (MBI) was used to measure daily activity performance. [Results] After the intervention, the mental practice group showed significant improvements in upper extremity function on the affected side and ADL scores compared to the control group. [Conclusion] The results of this study demonstrate mental practice intervention is effective at improving stroke patients’ upper extremity function and daily activity performance. In follow-up studies, securing a greater number of experimental subjects, and evaluation of the intervention’s therapeutic durability are required.Key words: Mental practice, Upper function, Stroke     

镜像治疗联合任务导向性训练对脑卒中偏瘫上肢功能的疗效观察CSCD

目的:探讨镜像治疗(MT)的启动联合任务导向性训练(TOT)对脑卒中偏瘫上肢功能恢复的疗效。方方法法:将符合入选条件的轻、中度上肢运动功能障碍的40例脑卒中住院患者按照随机数字表法分为观察组和对照组,每组20例。2组患者均接受常规康复治疗,对照组在常规康复治疗的基础上增加任务导向性训练,30 min/d,观察组在对照组的基础上增加镜像治疗,30 min/d,2组均5 d/周,共治疗4周。在治疗前后分别使用Fugl-Meyer评定上肢部分(FMA-UE)、上肢动作研究量表(ARAT)评估偏瘫上肢的运动功能,使用偏瘫上肢功能测试香港版(FTHUE-HK)评估偏瘫上肢的活动表现。结果:治疗前2组患者的FMA-UE评分、ARAT评分及FTHUE-HK分级比较,差异无统计学意义(P>0.05);治疗后2组患者的FMA-UE评分及ARAT评分均较治疗前显著提高(P<0.001),FTHUE-HK分级均较治疗前显著提高(P<0.05)。通过组间比较发现,治疗后观察组FTHUE-HK分级改善明显优于对照组(P<0.05);观察组FMA-UE评分的提高分值(11.40±6.29)分,明显优于对照组的提高分值(5.05±3.35)分,差异具有统计学意义(P<0.001);观察组ARAT评分的提高分值(6.25±3.67)分,明显优于对照组的提高分值(3.25±2.73)分,差异具有统计学意义(P<0.05)。结论:镜像治疗联合并作为任务导向性训练的启动时,其诱导的启动效应可以提高脑卒中后偏瘫上肢的运动功能和活动表现。     

The effects of mirror therapy with tasks on upper extremity function and self-care in stroke patients

[Purpose] The purpose of this study was to determine the effects of mirror therapy with tasks on upper extremity unction and self-care in stroke patients. [Subjects] Thirty participants were randomly assigned to either an experimental group (n=15) or a control group (n=15). [Methods] Subjects in the experimental group received mirror therapy with tasks, and those in the control group received a sham therapy; both therapies were administered, five times per week for six weeks. The main outcome measures were the Manual Function Test for the paralyzed upper limb and the Functional Independence Measure for self-care performance. [Results] The experimental group had more significant gains in change scores compared with the control group after the intervention. [Conclusion] We consider mirror therapy with tasks to be an effective form of intervention for upper extremity function and self-care in stroke patients.Key words: Mirror therapy, Stroke, Upper extremity function     

Effects of task-oriented training on upper extremity function and performance of daily activities by chronic stroke patients

[Purpose] The aim of this study was to determine the effects that task-oriented training has on upper extremity function and performance of daily activities by chronic stroke patients. [Subjects and Methods] Task-oriented training was applied to two chronic hemiplegic patients in this research. The training was provided to each patient for 30 minutes a day, five times a week for two weeks. The treatment program included six different types of training that could be performed by the patients themselves. Evaluation was performed four times, that is, once a week for three weeks before the intervention and once after the intervention. The change in upper extremity function was measured with the Manual Function Test, and the change in performance of daily activity was measured with the Functional Independence Measure. [Results] The upper extremity function of both subjects was improved after application of task-oriented training. However, in the performance of daily activities, subject one showed improvement compared to with before the intervention, whereas subject two showed the same results. [Conclusion] This research confirmed that two weeks of task-oriented training for chronic stroke patients is effective for improvement of upper extremity function and performance of daily activities by chronic stroke patients.Key words: Task-oriented training, Upper function, Stroke     

Modified constraint-induced movement therapy for clients with chronic stroke: interrupted time series (ITS) design

[Purpose] The purpose of this study was to investigate the impact that modified constraint-induced movement therapy has on upper extremity function and the daily life of chronic stroke patients. [Subjects and Methods] Modified constraint-induced movement therapy was conduct for 2 stroke patients with hemiplegia. It was performed 5 days a week for 2 weeks, and the participants performed their daily living activities wearing mittens for 6 hours a day, including the 2 hours of the therapy program. The assessment was conducted 5 times in 3 weeks before and after intervention. The upper extremity function was measured using the box and block test and a dynamometer, and performance daily of living activities was assessed using the modified Barthel index. The results were analyzed using a scatterplot and linear regression. [Results] All the upper extremity functions of the participants all improved after the modified constraint-induced movement therapy. Performance of daily living activities by participant 1 showed no change, but the results of participant 2 had improved after the intervention. [Conclusion] Through the results of this research, it was identified that modified constraint-induced movement therapy is effective at improving the upper extremity functions and the performance of daily living activities of chronic stroke patients.Key words: Constraint-induced movement therapy, Interrupted time series design, Stroke     

Effects of adjustment of transcranial direct current stimulation on motor function of the upper extremity in stroke patients

[Purpose] The purpose of this study was to examine the effects of transcranial direct current stimulation (tDCS) applied to the cerebral cortex motor area on the upper extremity functions of hemiplegic patients. [Subjects and Methods] Twenty four Patients with hemiplegia resulting from a stroke were divided into two groups: a tDCS group that received tDCS and physical therapy and a control group that received only physical therapy. A functional evaluation of the two groups was performed, and an electrophysiological evaluation was conducted before and after the experiment. Statistical analyses were performed to verify differences before and after the experiment. All statistical significance levels were set at 0.05. [Results] The results showed that functional evaluation scores for the elbow joint and hand increased after the treatment in both the experimental group and the control group, and the increases were statistically significantly different. [Conclusion] tDCS was effective in improving the upper extremity motor function of stroke patients. Additional research is warranted on the usefulness of tDCS in the rehabilitation of stroke patients in the clinical field.Key words: TDCS, Upper extremity and hand motor function, Stroke patients     

针刺配合作业疗法治疗脑卒中后上肢功能障碍的效果

目的观察靳三针疗法结合作业治疗对脑卒中后上肢功能障碍患者的影响。方法90 例脑卒中患者随机分为对照组(n=30)、观察组(n=30)和试验组(n=30)。对照组接受常规康复,观察组在常规康复基础上给予个体化作业治疗,试验组在常规康复的同时予靳三针结合作业治疗,疗程4 周。治疗前后采用上肢简化Fugl-Meyer评定(FMA)和Barthel 指数(BI)进行评定。结果各组治疗后FMA、BI 评分均较治疗前显著改善(P<0.001),FMA、BI 评分差值试验组显著高于观察组和对照组,观察组显著高于对照组(P<0.001)。结论在常规康复治疗基础上采用靳三针治疗和个体化作业治疗能明显改善脑卒中偏瘫患者的上肢功能,改善日常生活能力。     

Effects of a 12-hour neuromuscular electrical stimulation treatment program on the recovery of upper extremity function in sub-acute stroke patients: a randomized controlled pilot trial

[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.Key words: Neuromuscular electrical stimulation, Upper extremity function, Stroke     

运动观察疗法对恢复后期脑卒中患者手功能障碍的疗效研究

目的:探讨运动观察疗法(AOT)和重复经颅磁刺激(rTMS)分别结合作业治疗对恢复后期脑卒中患者手功能恢复的临床疗效差异.方法:将52例住院脑卒中患者随机分为对照组16例、AOT组19例和rTMS组17例.对照组接受常规的作业治疗,运动观察疗法组在此基础上增加AOT治疗,rTMS组在此基础上增加rTMS治疗,在治疗前及...     

低频重复经颅磁刺激联合作业治疗对脑卒中患者上肢运动功能恢复的临床研究

目的:探讨低频重复经颅磁刺激(rTMS)联合作业治疗对脑卒中恢复期患者上肢功能恢复的影响。方法:将60例脑卒中恢复期患者随机分为治疗组和对照组各30例。对照组接受常规的作业治疗,治疗组在常规作业治疗的同时给予1Hz的rTMS治疗。在治疗前及治疗4周后采用上肢Fugl-Meyer评分(FMA)、偏瘫上肢功能测试-香港版(FTHUE-HK)及改良的Barthel指数(MBI)对患者上肢功能进行评定。结果:治疗4周后,2组的FMA、FTHUE-HK评分和MBI均较治疗前明显提高(均P0.05),且治疗组各项评分均高于对照组(均P0.05)。结论:rTMS联合作业治疗可改善脑卒中恢复期患者上肢运动功能,提高日常生活活动能力。     

作业疗法改善脑卒中后偏侧感觉障碍及手功能的效果

目的探讨作业疗法对脑卒中后偏侧感觉障碍及手功能的作用。方法 50例脑卒中后存在偏侧感觉障碍的患者分为作业组(n=25)和对照组(n=25),在对照组常规治疗的基础上,作业组通过针对性的作业疗法进行感觉训练。治疗前后采用Fugl-Meyer上肢感觉评分以及手功能实用性评定进行评价。结果 2个月后,两组感觉评分和手实用能力均有改善,作业组优于对照组(P<0.05)。结论作业疗法能改善脑卒中患者的偏侧感觉障碍,还能提高手的实用能力。     

上肢康复训练系统在脑卒中偏瘫患者上肢功能康复中的应用

目的:观察上肢康复训练系统对脑卒中患者上肢功能康复的临床疗效。方法:脑卒中偏瘫上肢功能障碍患者42例,分为观察组22例和对照组20例。2组患者均接受常规药物治疗和康复训练。观察组在此基础上加用Rejoyce上肢康复训练。治疗前后采用Fugl-Meyer量表上肢部分(FMA-UE)、Rejoyce手功能测试(RAHFT)和功能独立性评定(FIM)评定2组疗效。结果:治疗4周后,2组FMA-UE、RAHFT及FIM评分治疗前后及组间比较均差异无统计学意义;治疗8周后,2组FMA-UE、RAHFT及FIM评分均较治疗前及治疗4周时明显提高(P0.05,0.01),且观察组更高于对照组(P0.05)。结论:Rejoyce上肢康复训练结合常规康复作业治疗能更好地改善脑卒中恢复期患者偏瘫上肢及手的功能,更有效地提高患者日常生活活动能力。     

肌电触发电刺激对偏瘫上肢功能的影响

目的探讨肌电触发电刺激对脑卒中偏瘫患者上肢功能的影响。方法将52例脑卒中偏瘫患者随机分成肌电触发电刺激组（27例）和对照组（25例）,两组均常规进行神经内科药物治疗、运动疗法和作业疗法治疗,肌电触发电刺激组加以肌电触发电刺激治疗。在患者入组时和治疗2个月时分别测定腕背屈时主动关节活动范围（AROM）,并用Fugl-Meyer评定法（FMA）评定患侧上肢功能。结果两组患者治疗前后组内比较和治疗后组间比较差异均有显著性意义（P〈0.05）;肌电触发电刺激组治疗后的AROM和FMA积分均优于对照组（P〈0.05）。结论肌电触发电刺激治疗联合常规康复治疗有助于改善偏瘫患者上肢的功能,其效果优于单独使用常规运动疗法和作业疗法治疗。     

Drinking Behavior Training for Stroke Patients Using Action Observation and Practice of Upper Limb Function

[Purpose] This study examined the effects of action observation and action practice on stroke patients’ upper limb function. [Subjects and Methods] The subjects were 33 chronic stroke patients who were randomly assigned to four groups. The action observation group (5 males, 3 females) watched a video of the task, the action practice group (5 males, 4 females) performed the action, the combined action observation-action practice group (5 males, 4 females) watched the video of the task and practiced the action, and the control group (4 males, 3 females) did not perform either action observation or action practice. The video used in the action observational physical training comprised a scene of an adult male picking up a cup, bringing it to his mouth in order to touch his mouth, and then returning the cup to its initial position. [Results] Improvements in drinking behavior functions were observed immediately after the experiment and one week later. After the intervention, the number of drinking motions had increased the most in the combination group. One week after the experiment, there were increases in the action observation, action training, and combination groups. [Conclusion] A combination of action observation and action training is the most effective treatment method, and action training is a desirable second to combined therapy.Key words: Action observation, Drinking behavior training, Upper limb function     

运动反馈训练对偏瘫患者上肢运动功能和日常生活活动能力的疗效

目的 探讨了Armeo Spring上肢运动反馈训练对偏瘫患者上肢运动功能和日常生活活动能力的疗效。 方法 52例偏瘫患者随机数字表法分为观察组和对照组,各26例。对照组进行常规康复训练的基础上增加每日1次作业疗法训练,观察组在常规康复训练的基础上增加每日1次Armeo Spring上肢运动反馈的作业疗法训练,2组治疗时间均为5个月,治疗前和治疗后分别对2组患者上肢和手的主动关节活动度测量（AROM）、改良Barthel 指数(Modify Barthel Index,MBI)、Fugl-Meyer 评定量表(Fugl-Meyer motor assessment scale,FMA）和简易上肢机能检查（Simple Test for Evaluating hand Function,STEF）进行评价。 结果 治疗前2组患者MBI、FMA和WMFT比较差异无统计学意义（P＞0.05）;治疗后2组患者MBI、FMA和WMFT较治疗前比较差异有统计学意义（P＜0.05）,观察组MBI、FMA和WMFT较对照组差异均有显著统计学意义（P<0.05）,且观察组各项指标改善均优于对照组。 结论 通过上肢运动反馈训练联合常规康复可明显改善偏瘫患者上肢运动功能和日常生活活动能力。     

镜像结合动作观察疗法对脑卒中患者上肢功能及tau蛋白、GDNF表达的影响

目的：探讨镜像结合动作观察疗法对脑卒中偏瘫患者上肢功能及血清tau蛋白、胶质细胞源性神经营养因子（GDNF）表达的影响。方法：脑卒中偏瘫患者135例,随机分成研究组、对照1组、对照2组,每组均45例。研究过程中每组均有2例脱落。3组患者均接受康复治疗,在此基础上,研究组采取镜像结合动作观察疗法,对照1组采取镜像疗法,对照2组实施动作观察疗法。比较3组神经功能恢复情况、上肢功能、日常生活活动能力的变化及血清tau蛋白、GDNF表达水平。结果：治疗4周后,3组临床神经功能缺损程度量表（CNDS）评分与治疗前相比均降低（P＜0.05）,且研究组CNDS评分较对照1、2组低（P＜0.05）;3组Fugl-Meyer运动功能评分法（FMA）中上肢功能评分、Barthel指数评定量表（BI）评分与治疗前相比均增高（P＜0.05）,且研究组上肢功能评分、BI评分均较对照1、2组高（P＜0.05）;3组血清tau蛋白表达水平与治疗前相比均降低（P＜0.05）,血清GDNF表达水平与治疗前相比均升高（P＜0.05）,且研究组血清tau蛋白水平较对照1、2组低（P＜0.05）,血清GDNF水平较对照1、2组高（P＜0.05）。结论：对卒中偏瘫患者实施镜像结合动作观察疗法,可显著降低患者神经功能缺损程度,明显改善患者上肢功能及日常生活活动能力,且能有效调节血清tau蛋白、GDNF的表达。     

Visual Biofeedback Balance Training Using Wii Fit after Stroke: A Randomized Controlled Trial

[Purpose] The aim of the present study was to investigate the effect of balance training with visual biofeedback on balance, body symmetry, and function among individuals with hemiplegia following a stroke. [Subjects and Methods] The present study was performed using a randomized controlled clinical trial with a blinded evaluator. The subjects were twenty adults with hemiplegia following a stroke. The experimental group performed balance training with visual biofeedback using Wii Fit^® together with conventional physical therapy. The control group underwent conventional physical therapy alone. The intervention lasted five weeks, with two sessions per week. Body symmetry (baropodometry), static balance (stabilometry), functional balance (Berg Balance Scale), functional mobility (Timed Up and Go test), and independence in activities of daily living (Functional Independence Measure) were assessed before and after the intervention. [Results] No statistically significant differences were found between the experimental and control groups. In the intragroup analysis, both groups demonstrated a significant improvement in all variables studied. [Conclusion] The physical therapy program combined with balance training involving visual biofeedback (Wii Fit^®) led to an improvement in body symmetry, balance, and function among stroke victims. However, the improvement was similar to that achieved with conventional physical therapy alone.Key words: Postural balance, Stroke, Visual biofeedback