學院

醫學院

系所

職能治療學系

題名

Unilateral vs. Bilateral hybrid approaches for upper limb rehabilitation in chronic stroke.

作者

Hung, C-S., Lin, K-C.*, Chang W-Y., Huang W-C., Chang Y-J., Chen C-L., Yao, K-P., & Lee, Y-Y.

期刊名稱

Archives of Physical Medicine and Rehabilitation. (SCIE 期刊)

發表日期

2019

著作性質

原著

語文

英文

關鍵字

stroke; hybrid therapy; constraint, induced therapy; bilateral arm training; robot, assisted therapy

摘要

Objective: To investigate the effects of unilateral hybrid therapy (UHT), bilateral hybrid therapy (BHT), and the comparison treatment of robot-assisted therapy (RT) alone in patients with chronic stroke.

Design: A single-blind, randomized controlled trial

Setting: Four hospitals

Participants: Forty-four outpatients with chronic stroke, with mild to moderate motor

impairment.

Intervention: UHT combined unilateral RT and modified constraint-induced therapy. BHT combined bilateral RT and bilateral arm training. RT group received both the unilateral and the bilateral RT protocols. The intensity for three groups was 1.5 hours/day, 3 days/week, for 6 weeks.

Outcome measures: The Fugl-Meyer Assessment (FMA) and the Stroke Impact Scale Version 3.0 (SIS) immediately and at 3 months after treatment, the Wolf Motor Function Test (WMFT), and the Nottingham Extended Activities of Daily Living (NEADL) scale immediately after treatment.

Results: The results favored the BHT over 20 the UHT on FMA total score and distal score at posttest (p = 0.03 and 0.04) and favored the BHT over the UHT and RT on the follow-up FMA distal score (p = 0.047 and 0.03). The 3 groups improved significantly on the WMFT and SIS immediately after treatment, without between-group differences. RT led to significantly greater improvement on the mobility domain of NEADL than the BHT at postintervention (p < 0.01).

Conclusions: The findings suggest that BHT had better treatment effect on UE motor function, especially in distal motor function at follow-up, and that RT showed benefit on functional ambulation.