脳卒中急性期上肢麻痺患者に対する病棟実施型CI療法の効果

Effects of ward-operated CI therapy for stroke patients with acute upper limb paralysis

要旨：本試験は，脳卒中急性期脳卒中患者に対し，病棟での自主練習を含むmodified CI療法（以下，病棟実施型CI療法）が麻痺手の機能・行動に与える影響を調べることを目的に実施した．方法は，急性期脳卒中患者に対し，訓練室で行われる通常のmodified CI療法（以下，mCI療法）と病棟実施型CI療法が麻痺手の機能と使用行動に与える影響について，後ろ向きコホート試験で探索的に比較した．その結果，両群とも麻痺手の機能・行動は介入前後に有意に改善した．しかし，群間比較では，麻痺手の使用行動のみ，病棟実施型CI療法が，通常のmCI療法に比べ，有意に改善した．病棟実施型CI療法は，実生活の麻痺手の使用行動に影響を与える可能性がある．

　Purpose: This trial aimed to determine the efficacy of standard modified CI therapy (mCI therapy) with self-training in hospital wards (ward-based mCI therapy) on upper-extremity function and behavior. Method: Through comparing the standard mCI therapy, which focuses on one extremity, with the ward-based mCI therapy using retrospective cohort design for acute stroke patients, we investigated upper-extremity motor function and behavior. Results: Post hoc analysis revealed that both groups significantly exhibited improved upper-extremity function and behavior. However, comparison between groups revealed that the ward-based mCI therapy significantly improved the affected upper-extremity behavior more than the standard mCI therapy. Conclusion: The ward-based CI therapy might have a greater effect on the behavior of the affected upper-extremity in real life.