學院

醫學院

系所

職能治療學系

題名

Constraint-induced therapy with trunk restraint for improving functional outcomes and trunk-arm control after stroke: A randomized controlled trial

作者

Wu, C-Y., Chen, Y-A., Lin, K-C.*, Chao, C-P., & Chen, Y-T.

期刊名稱

Physical Therapy (SCI 期刊)

發表日期

2012年

著作性質

原著

語文

英文

關鍵字

activities of daily living, patient-oriented report, quality of life, constraint-induced therapy, trunk restraint

摘要

Background. Constraint-induced therapy combined with trunk restraint (CIT-TR) improves arm movement and trunk compensation. Whether participants who receive CIT-TR can translate the benefits to real-life circumstances awaits further investigation. Objective. We investigated the effects of distributed CIT-TR (dCIT-TR) on motor and daily function, and quality of life (QOL), as well as arm-trunk control. Design and Setting. This study was a double-blinded and randomized controlled design, and took place at 4 hospitals. Patients. 57 patients who were 6 to 55 months poststroke participated. Intervention. Participants received a dose-matched intervention (2 hours/day, 5 days/week, for 3 weeks) of dCIT-TR, or dCIT, or control therapy. Measurements. The Action Research Arm Test (ARAT), Motor Activity Log (MAL), Frenchay Activity Index (FAI), and Stroke Impact Scale (SIS) were used to evaluate motor and daily function, and QOL. Reaching kinematics data were recorded. Results. The dCIT-TR and dCIT groups exhibited higher overall scores on the ARAT, FAI, and hand function of the SIS, and better quality of movement on the MAL, than the control group. The dCIT-TR group further demonstrated greater improvements in the grip subtest of the ARAT and the outdoor activities scale of the FAI than the dCIT and/or control groups. However, the dCIT participants reported greater improvements in the strength domain of the SIS after training than the dCIT-TR and control groups. Limitations. Future research with a large sample size is needed. Conclusions. Patients receiving dCIT-TR were able to translate the gains in arm-trunk control into functional performance and QOL, specifically in grip function and outdoor activities. The decreased self-perception on strength after dCIT-TR may require a long-term study to examine the recovery course of force output.