With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be e...With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.展开更多
OBJECTIVE： The aim of this meta-analysis was to evaluate the clinical efficacy of constraint-induced movement therapy in acute and sub-acute stroke. DATA SOURCES： The key words were stroke, cerebrovascular accident,...OBJECTIVE： The aim of this meta-analysis was to evaluate the clinical efficacy of constraint-induced movement therapy in acute and sub-acute stroke. DATA SOURCES： The key words were stroke, cerebrovascular accident, constraint-induced therapy, forced use, and randomized controlled trial. The databases, including China National Knowledge Infrastructure, WanFang, Weipu Information Resources System, Chinese Biomedical Literature Database, PubMed, Med- line, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, were searched for studies on randomized controlled trials for treating acute or sub-acute stroke published before March 2016. DATA SELECTION： We retrieved relevant randomized controlled trials that compared constraint-induced movement therapy in treatment of acute or sub-acute stroke with traditional rehabilitation therapy （tradi- tional occupational therapy）. Patients were older than 18 years, had disease courses less than 6 months, and were evaluated with at least one upper extremity function scale. Study quality was evaluated, and data that met the criteria were extracted. Stata 11.0 software was used for the meta-analysis. OUTCOME MEASURES： Fugl-Meyer motor assessment of the arm, the action research-arm test, a motor activity log for amount of use and quality of movement, the Wolf motor function test, and a modified Bar- thel index. RESULTS： A total of 16 prospective randomized controlled trials （379 patients in the constraint-induced movement-therapy group and 359 in the control group） met inclusion criteria. Analysis showed significant mean differences in favor of constraint-induced movement therapy for the Fugl-Meyer motor assessment of the arm （weighted mean difference （WMD） = 10.822; 95% confidence intervals （95% CI）： 7.419-14.226）, the action research-arm test （WMD = 10.718; 95% CI： 5.704-15.733）, the motor activity log for amount of use and quality of movement （WMD = 0.812; 95% CI： 0.331-1.293） and the modified Barthel index （WMD = 10.706; 95% CI： 4.417-16.966）. CONCLUSION： Constraint-induced movement therapy may be more beneficial than traditional rehabili- tation therapy for improving upper limb function after acute or sub-acute stroke.展开更多
目的系统评价上肢强化训练对脑瘫儿童上肢运动功能的效果。方法构建PICO架构,检索PubMed、Embase、Cochrane Library、Scopus、Web of Science、中国知网、中国生物医学文献数据库、维普和万方数据库,搜集关于上肢强化训练改善脑瘫儿童...目的系统评价上肢强化训练对脑瘫儿童上肢运动功能的效果。方法构建PICO架构,检索PubMed、Embase、Cochrane Library、Scopus、Web of Science、中国知网、中国生物医学文献数据库、维普和万方数据库,搜集关于上肢强化训练改善脑瘫儿童上肢运动功能的随机对照试验,检索时限均为2010年1月至2024年3月。按照Cochrane系统评价手册和物理治疗证据数据库量表对纳入文献进行质量评价,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4和Stata 17.0进行网状Meta分析。结果共纳入27篇文献,包括1173例患者,涉及3种上肢强化训练。强制性运动疗法、改良强制性运动疗法和手-臂双侧强化训练均可提高辅助手功能评分与Peabody精细运动功能评分;强制性运动疗法和改良强制性运动疗法可提高上肢技能质量量表评分;手-臂双侧强化训练可提高儿童生活功能量表评分。在提高辅助手功能、上肢技能质量量表评分和Peabody精细运动功能评分方面,强制性运动疗法为最佳干预方式;在提高儿童生活功能量表评分方面,手-臂双侧强化训练为最佳干预方式。结论上肢强化训练可显著改善脑瘫儿童的上肢运动功能、精细运动功能和日常生活活动能力,强制性运动疗法在改善上肢运动功能和精细运动功能方面效果最好,手-臂双侧强化训练在提高日常生活活动能力方面疗效最佳。展开更多
目的系统评价作业治疗对脑卒中患者上肢功能、活动能力、生活质量和抑郁的影响。方法检索中国生物医学数据库、知网、万方、维普、PubMed、Web of Science、Cochrane Library、Embase从建库到2023年12月关于作业治疗对脑卒中患者的随机...目的系统评价作业治疗对脑卒中患者上肢功能、活动能力、生活质量和抑郁的影响。方法检索中国生物医学数据库、知网、万方、维普、PubMed、Web of Science、Cochrane Library、Embase从建库到2023年12月关于作业治疗对脑卒中患者的随机对照试验。采用Revman5.4软件进行Meta分析。结果纳入20篇文献,共2596例脑卒中病人。Meta分析结果显示,作业治疗可以改善脑卒中患者的上肢功能[SMD=1.61,95%CI:(0.76,2.46),P=0.0002],提高日常生活活动能力[SMD=1.17,95%CI:(0.77,1.58),P<0.00001],改善生活质量[SMD=3.54,95%CI:(1.89,5.2),P<0.0001],降低抑郁[SMD=-1.02,95%CI:(-1.51,-0.53),P<0.0001]。结论作业治疗能够改善脑卒中患者的上肢功能,提高日常生活活动能力和生活质量,缓解抑郁情绪,促进脑卒中患者的康复效果。展开更多
In the article, 152 cases of numbness of upper extremities, 121 cases of wind-stroke and 11 cases of ulnar neuritis were treated by acupoint Tianding (LI 17) as a chief point, inwhich the total effective rate was 90.1...In the article, 152 cases of numbness of upper extremities, 121 cases of wind-stroke and 11 cases of ulnar neuritis were treated by acupoint Tianding (LI 17) as a chief point, inwhich the total effective rate was 90.13%, 85%, and 100% respectively.展开更多
目的基于世界卫生组织国际分类家族(WHO-FICs)构建作业治疗改善脑卒中上肢功能的PICO架构,并分析主要作业疗法改善脑卒中患者上肢功能的效果。方法运用WHO-FICs框架,检索Web of Science、PubMed、CNKI、SinoMed等数据库,收集建库至2022...目的基于世界卫生组织国际分类家族(WHO-FICs)构建作业治疗改善脑卒中上肢功能的PICO架构,并分析主要作业疗法改善脑卒中患者上肢功能的效果。方法运用WHO-FICs框架,检索Web of Science、PubMed、CNKI、SinoMed等数据库,收集建库至2022年10月关于作业治疗干预脑卒中上肢功能的相关文献,并进行系统综述。结果最终纳入10项随机对照试验,382例参与者(≥18岁),来自6个国家,主要来源于康复医学、物理和康复医学、神经科学、生物工程医学、作业治疗等研究领域,发表年限集中于2013年以后。纳入文献物理治疗证据数据库(PEDro)量表评分平均7.5分。基于WHO-FICs框架,纳入文献中涉及的疾病类型涵盖脑出血(8B00)、缺血性脑卒中(8B11)、蛛网膜下腔出血(8B01)、肌张力和异常反射(MB47)、偏瘫(MB53)。主要功能障碍包括关节活动功能(b710)、关节稳定性功能(b715)、肌肉力量功能(b730)、肌张力功能(b735)、运动反射功能(b750)、随意运动控制功能(b760)、不随意运动功能(b765)。主要活动受限和参与局限包括上肢的活动和参与,如举起和搬运物体(d430),手和手臂的使用(d445),精巧手的使用(d440);以及日常生活活动和社会参与能力,如自理(d510-d570),家庭生活(d610-d660),主要生活领域(d810-d879),社区、社会和公民生活(d910-d950)。涉及身体功能的治疗类干预措施有肌肉功能电刺激(MU2.SC.BP)、协助和指导运动功能训练(MV2.PG.ZZ);涉及活动和参与的治疗类干预措施有举起和搬运物体训练(SIA.PH.ZZ)、使用精巧手的训练(SIG.PH.ZZ)、使用上肢和手的训练(SIJ.PH.ZZ)、自理的干预措施(SM1-SMH)、主要生活领域的干预措施(SO2-SOD)、游戏训练(SXD.PH.ZZ)。每次干预15~60 min,每周3~10次,持续3~8周。干预场所一般为医院或居家。干预效果分为3个层面:身体功能层面,涉及神经运动传导功能、反射功能、随意运动控制能力、协调性与速度改善,关节活动度和握力增加;活动和参与层面,涉及上肢活动能力和速度、手的精细功能和速度、上肢活动参与的频率和质量,日常生活活动能力提高,参与日常活动任务的困难程度降低;生活质量和福祉层面,涉及获得愉悦感和成就感,生活质量提高。结论基于WHO-FICs构建了作业治疗改善脑卒中上肢功能效果的PICO架构。涉及的疾病类型涵盖脑出血、缺血性脑卒中、蛛网膜下腔出血、肌张力和异常反射以及偏瘫。上肢运动功能障碍主要有随意运动控制功能障碍,运动反射功能减弱或亢进,肌张力异常,肌肉协调障碍,关节活动稳定性差,肌力减退等,活动受限和参与局限性表现为手臂和手的活动参与功能障碍,手的精细活动功能障碍,影响日常生活活动和社会参与能力。涉及身体功能的治疗类干预措施有基于脑机接口的神经肌肉电刺激治疗、单上肢镜像训练;涉及活动和参与的治疗类干预措施有动作观察训练、双上肢镜像训练、任务导向训练、双上肢训练及上肢机器人训练。健康和功能效益主要表现为上肢运动功能、上肢的活动和参与水平、日常生活活动能力和社会参与能力提高,生活质量与福祉改善。展开更多
文摘With the visual illusion of the mirror,Mirror Therapy,models the primary somatosensory cortex,cortical and muscular excitability,stimulating cortical reorganization and sensorimotor recovery.Studies have shown to be effective in improving motor function in short and medium term,in activities of daily living,in visuospatial neglect and in reducing pain,especially in patients with complex regional pain syndrome.Objective:To report the perception of Occupational Therapists regarding the application of Mirror Therapy in professional practice.Specifically,what factors lead to its application,what are the effects and benefits of the technique,what are its advantages and limitations.Results:In the perception of Occupational Therapists,the Mirror Therapy technique has the following benefits:significant decrease in pain,improved sensitivity and functionality of the upper limb,unblocking movements in the affected limb,decreased phantom pain;as negative aspects:difficulties in spatial/environmental control,patient's perceptual/cognitive skills,high level of concentration/attention,absence of scientific evidence in neurological conditions.Conclusion:For the interviewed Occupational Therapists,the Mirror Therapy is a safe and useful technique to be applied in your professional practice that has been showing positive results in the functional recovery of patients,however,it lacks studies that identify the appropriate time to start its application and the explanation of an intervention protocol.
基金supported by the Natural Science Foundation of Shandong Province of China,No.2014ZRB14502
文摘OBJECTIVE： The aim of this meta-analysis was to evaluate the clinical efficacy of constraint-induced movement therapy in acute and sub-acute stroke. DATA SOURCES： The key words were stroke, cerebrovascular accident, constraint-induced therapy, forced use, and randomized controlled trial. The databases, including China National Knowledge Infrastructure, WanFang, Weipu Information Resources System, Chinese Biomedical Literature Database, PubMed, Med- line, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, were searched for studies on randomized controlled trials for treating acute or sub-acute stroke published before March 2016. DATA SELECTION： We retrieved relevant randomized controlled trials that compared constraint-induced movement therapy in treatment of acute or sub-acute stroke with traditional rehabilitation therapy （tradi- tional occupational therapy）. Patients were older than 18 years, had disease courses less than 6 months, and were evaluated with at least one upper extremity function scale. Study quality was evaluated, and data that met the criteria were extracted. Stata 11.0 software was used for the meta-analysis. OUTCOME MEASURES： Fugl-Meyer motor assessment of the arm, the action research-arm test, a motor activity log for amount of use and quality of movement, the Wolf motor function test, and a modified Bar- thel index. RESULTS： A total of 16 prospective randomized controlled trials （379 patients in the constraint-induced movement-therapy group and 359 in the control group） met inclusion criteria. Analysis showed significant mean differences in favor of constraint-induced movement therapy for the Fugl-Meyer motor assessment of the arm （weighted mean difference （WMD） = 10.822; 95% confidence intervals （95% CI）： 7.419-14.226）, the action research-arm test （WMD = 10.718; 95% CI： 5.704-15.733）, the motor activity log for amount of use and quality of movement （WMD = 0.812; 95% CI： 0.331-1.293） and the modified Barthel index （WMD = 10.706; 95% CI： 4.417-16.966）. CONCLUSION： Constraint-induced movement therapy may be more beneficial than traditional rehabili- tation therapy for improving upper limb function after acute or sub-acute stroke.
文摘目的系统评价作业治疗对脑卒中患者上肢功能、活动能力、生活质量和抑郁的影响。方法检索中国生物医学数据库、知网、万方、维普、PubMed、Web of Science、Cochrane Library、Embase从建库到2023年12月关于作业治疗对脑卒中患者的随机对照试验。采用Revman5.4软件进行Meta分析。结果纳入20篇文献,共2596例脑卒中病人。Meta分析结果显示,作业治疗可以改善脑卒中患者的上肢功能[SMD=1.61,95%CI:(0.76,2.46),P=0.0002],提高日常生活活动能力[SMD=1.17,95%CI:(0.77,1.58),P<0.00001],改善生活质量[SMD=3.54,95%CI:(1.89,5.2),P<0.0001],降低抑郁[SMD=-1.02,95%CI:(-1.51,-0.53),P<0.0001]。结论作业治疗能够改善脑卒中患者的上肢功能,提高日常生活活动能力和生活质量,缓解抑郁情绪,促进脑卒中患者的康复效果。
文摘In the article, 152 cases of numbness of upper extremities, 121 cases of wind-stroke and 11 cases of ulnar neuritis were treated by acupoint Tianding (LI 17) as a chief point, inwhich the total effective rate was 90.13%, 85%, and 100% respectively.
文摘目的基于世界卫生组织国际分类家族(WHO-FICs)构建作业治疗改善脑卒中上肢功能的PICO架构,并分析主要作业疗法改善脑卒中患者上肢功能的效果。方法运用WHO-FICs框架,检索Web of Science、PubMed、CNKI、SinoMed等数据库,收集建库至2022年10月关于作业治疗干预脑卒中上肢功能的相关文献,并进行系统综述。结果最终纳入10项随机对照试验,382例参与者(≥18岁),来自6个国家,主要来源于康复医学、物理和康复医学、神经科学、生物工程医学、作业治疗等研究领域,发表年限集中于2013年以后。纳入文献物理治疗证据数据库(PEDro)量表评分平均7.5分。基于WHO-FICs框架,纳入文献中涉及的疾病类型涵盖脑出血(8B00)、缺血性脑卒中(8B11)、蛛网膜下腔出血(8B01)、肌张力和异常反射(MB47)、偏瘫(MB53)。主要功能障碍包括关节活动功能(b710)、关节稳定性功能(b715)、肌肉力量功能(b730)、肌张力功能(b735)、运动反射功能(b750)、随意运动控制功能(b760)、不随意运动功能(b765)。主要活动受限和参与局限包括上肢的活动和参与,如举起和搬运物体(d430),手和手臂的使用(d445),精巧手的使用(d440);以及日常生活活动和社会参与能力,如自理(d510-d570),家庭生活(d610-d660),主要生活领域(d810-d879),社区、社会和公民生活(d910-d950)。涉及身体功能的治疗类干预措施有肌肉功能电刺激(MU2.SC.BP)、协助和指导运动功能训练(MV2.PG.ZZ);涉及活动和参与的治疗类干预措施有举起和搬运物体训练(SIA.PH.ZZ)、使用精巧手的训练(SIG.PH.ZZ)、使用上肢和手的训练(SIJ.PH.ZZ)、自理的干预措施(SM1-SMH)、主要生活领域的干预措施(SO2-SOD)、游戏训练(SXD.PH.ZZ)。每次干预15~60 min,每周3~10次,持续3~8周。干预场所一般为医院或居家。干预效果分为3个层面:身体功能层面,涉及神经运动传导功能、反射功能、随意运动控制能力、协调性与速度改善,关节活动度和握力增加;活动和参与层面,涉及上肢活动能力和速度、手的精细功能和速度、上肢活动参与的频率和质量,日常生活活动能力提高,参与日常活动任务的困难程度降低;生活质量和福祉层面,涉及获得愉悦感和成就感,生活质量提高。结论基于WHO-FICs构建了作业治疗改善脑卒中上肢功能效果的PICO架构。涉及的疾病类型涵盖脑出血、缺血性脑卒中、蛛网膜下腔出血、肌张力和异常反射以及偏瘫。上肢运动功能障碍主要有随意运动控制功能障碍,运动反射功能减弱或亢进,肌张力异常,肌肉协调障碍,关节活动稳定性差,肌力减退等,活动受限和参与局限性表现为手臂和手的活动参与功能障碍,手的精细活动功能障碍,影响日常生活活动和社会参与能力。涉及身体功能的治疗类干预措施有基于脑机接口的神经肌肉电刺激治疗、单上肢镜像训练;涉及活动和参与的治疗类干预措施有动作观察训练、双上肢镜像训练、任务导向训练、双上肢训练及上肢机器人训练。健康和功能效益主要表现为上肢运动功能、上肢的活动和参与水平、日常生活活动能力和社会参与能力提高,生活质量与福祉改善。
