Upper Limb Isokinetic Strengthening Versus, Passive Mobilization in Patients With Chronic Stroke: A Randomized Controlled Trial

被引：17

作者：

Coroian, Flavia ^{[1
,2
]}

Jourdan, Claire ^{[1
]}

Bakhti, Karima ^{[1
,2
]}

Palayer, Claire ^{[1
]}

Jaussent, Audrey ^{[4
]}

Picot, Marie-Christine ^{[4
]}

Mottet, Denis ^{[2
]}

Julia, Marc ^{[1
,2
]}

Bonnin, Huey-Yune ^{[2
,3
]}

Laffont, Isabelle ^{[1
,2
]}

机构：

[1] Montpellier Univ Hosp, Phys Med & Rehabil Dept, 291 Blvd Gaston Giraud, F-34191 Montpellier 5, France

[2] Montpellier Univ, Euromov, Montpellier, France

[3] Nimes Univ Hosp, Phys Med & Rehabil Dept, Grau Du Roi, France

[4] Montpellier Univ Hosp, Med Informat Dept, Montpellier, France

来源：

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2018年 / 99卷 / 02期

关键词：

Dynamometer; Muscle strength; Rehabilitation; Stroke; Upper extremity; ROBOT-ASSISTED THERAPY; UPPER EXTREMITY FUNCTION; TACTILE STIMULATION; RECOVERY; REHABILITATION; IMPAIRMENT; DISABILITY; DIFFERENCE; DEFICITS; PEOPLE;

D O I：

10.1016/j.apmr.2017.08.490

中图分类号：

R49 [康复医学];

学科分类号：

100215 ;

摘要：

Objective: To assess the benefit of isokinetic strengthening of the upper limb (UL) in patients with chronic stroke as compared to passive mobilization. Design: Randomized blinded assessor controlled trial. Setting: Physical Medicine and Rehabilitation departments of 2 university hospitals. Participants: Patients (N=20) with incomplete hemiplegia (16 men; mean age, 64y; median time since stroke, 32mo). Interventions: A 6-week comprehensive rehabilitation program, 3d/wk, 3 sessions/d. In addition, a 45-minute session per day was performed using an isokinetic dynamometer, with either isokinetic strengthening of elbow and wrist flexors/extensors (isokinetic strengthening group) or passive joint mobilization (control group). Main Outcome Measures: The primary endpoint was the increase in Upper Limb Fugl-Meyer Assessment (UL-FMA) score at day 45 (t1 ). Secondary endpoints were increases in UL-FMA scores, Box and Block Test scores, muscle strength, spasticity, and Barthel Index at t1, t2 (3mo), and t3 (6mo). Results: Recruitment was stopped early because of excessive fatigue in the isokinetic strengthening group. The increase in UL-FMA score at t1 was 3.5 +/- 4.4 in the isokinetic strengthening group versus 6.0 +/- 4.5 in the control group (P=.2). Gains in distal UL-FMA scores were larger (3.1 +/- 2.8) in the control group versus 0.6 +/- 2.5 in the isokinetic strengthening group (P=.05). No significant group difference was observed in secondary endpoints. Mixed models confirmed those results. Regarding the whole sample, gains from baseline were significant for the UL-FMA at t1 (+4.8; P<.001), t2, and t3 and for the Box and Block Test at t1 (+3; P=.013) and t2. Conclusions: In a comprehensive rehabilitation program, isokinetic strengthening did not show superiority to passive mobilization for UL rehabilitation. Findings also suggest a sustained benefit in impairments and function of late UL rehabilitation programs for patients with stroke. (C) 2017 by the American Congress of Rehabilitation Medicine

引用

页码：321 / 328

页数：8

共 40 条

[31] Clinically Important Differences for the Upper-Extremity Fugl-Meyer Scale in People With Minimal to Moderate Impairment Due to Chronic Stroke [J].