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(摘錄自BMCNeurol.2019 Aug 1519(1):196)
Background: Recovery of upper limb function in individuals after a stroke remains challenging. Modified constraint-induced movement therapy (m-CIMT) has strong evidence for increasing the use and recovery of sensorimotor function of the paretic upper Jimb. Recent studies have shown that priming with aerobic exercise prior to task-specific training potentiates upper limb recovery in individuals with stroke. This protocol describes a randomized clinical trial designed to determine whether priming with moderate-high intensity aerobic exercise prior to m-CIMT will improve the manual dexterity of the paretic upper limb in individuals with chronic hemiparesis.
Methods: Sixty-two individuals with chronic hemiparesis will be randomized into two groups: Acrobic exercise + m-CIMT or Stretching + m-CIMT. m-CIMT includes 1) restraint of the nonparetic upper limb for 90% of waking hours, 2) intensive task-oriented fraining of the paretic upper limb for 3 h/day for 10 days and 3) behavior interventions for improving treatment adherence. Acrobic exercise will be conducted on a stationary bicycle at intervals of moderate to high intensity. Participants will be evaluated at baseline, 3, 30, and 90 days postintervention by the following instruments: Motor Activity Log, Nottinghan Sensory Assessmnent, Wolf Motor Function Test, Box and Block Test, Ninc-Hole Peg Test, Stroke Specific Quality of Life Scale and three-dimensional kinematics. The data will be tested for normality and homogeneity. Parametric data will be analyzed by two-way ANOVA with repeated measures and Bonferroni's adjustment. For nonparametric data, the Friedman test followed by the Wilcoxon test with Bonferroni's adjustment will be used to compare the ratings for each group. To compare the groups in cach assessment, the Mann-Whitney tost will be used.
Discussion: This study will provide valuable informnation about the effect of motor priming for fine upper limb skill improvement in beople with chronic poststroke hemiparesis, bringing new evidence about the association of two therapies commonly used in clinical bractice.
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