比较分散练习和集中练习对急性中风患者功能恢复和脑源性神经营养因子(BDNF)的影响

IF 0.8 Q4 CLINICAL NEUROLOGY
Madhurika Kate, K. V. Kumar, Akshatha Nayak, Arun Shirali
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引用次数: 0

摘要

在全球范围内,中风被认为是主要的健康问题之一,在老龄化人口中导致残疾。康复是重新学习因脑损伤而丧失的技能的过程。影响神经损伤后运动学习的因素很多,练习是影响失能运动技能再学习或再习得的关键因素之一。练习可以是顺序的(阻塞的或随机的),安排的(集中的或分散的),或整体的或部分的练习。该研究观察了练习时间表变化对运动和功能恢复的影响。32名急性卒中受试者被招募并平均分为两组(16名集中组和16名分散组)。两组都接受了一项为期两周的加速技能习得计划(ASAP),每周六次。结果前后测量包括卒中康复运动评估(STREAM)用于运动恢复,改良Barthel指数(MBI)用于功能恢复,脑源性神经营养因子(BDNF)用于神经可塑性。集体练习组干预前STREAM总分、MBI和BDNF的中位数分别为23.5、19和0.65,干预后STREAM总分、MBI和BDNF的中位数分别为40.5、60.5和0.75。分布练习组的pre-STREAM总分、MBI和BDNF的中位数分别为23.5、6.5和0.70,而post-STREAM总分、MBI和BDNF的中位数分别为41、45.5和0.80。两组患者STREAM、MBI、BDNF的前后值比较,p值均<0.05。组间比较STREAM、MBI、BDNF的中位变化评分P≥0.05。两组在干预后都有显著的恢复,这是基于ASAP设计的,关于减轻损伤,追求熟练的运动导致显著的功能增益。合适的时间和最佳的剂量成为急性脑卒中患者功能恢复的有效成分。分散的练习可能会增加间隔的效果,从而更容易学习和准确的技能。本研究表明,在急性脑卒中康复中,分散练习可作为常规临床练习的一部分,以促进功能恢复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing distributed versus massed practice on functional recovery and Brain-Derived Neurotrophic Factor (BDNF) in acute stroke subjects
Globally, stroke is known to be one of the major health problems, resulting in disability among an aging population. Rehabilitation is a process of re-learning of skills, lost due to brain injury. Many factors influence motor learning post neurological insult and practice is one of the key factors which influence relearning or reacquisition of lost motor skills. Practice can be varied concerning order (blocked or random), scheduling (massed or distributed), or whole and part practice. The study observed the effect of variations in practice schedules on motor and functional recovery. Thirty-two acute stroke subjects were recruited and equally divided into two groups (16 in massed and 16 in distributed). Both groups received an accelerated skill acquisition program (ASAP) for six sessions a week for 2 weeks. Pre- and post-outcome measures included stroke rehabilitation assessment of movement (STREAM) for motor recovery, modified Barthel index (MBI) for functional recovery, and brain-derived neurotrophic factor (BDNF) for neuroplasticity. The median scores of participants in the massed practice group before the intervention, of STREAM total, MBI, and BDNF were 23.5, 19, and 0.65, respectively, whereas post values of STREAM total, MBI, and BDNF were 40.5, 60.5, and 0.75, respectively. The median scores of the distributed practice group of the pre-STREAM total, MBI, and BDNF were 23.5, 6.5, and 0.70, respectively, whereas the post-STREAM total, MBI, and BDNF were 41, 45.5, and 0.80, respectively. P-value was reported to be <0.05 while comparing pre- and post-values of STREAM, MBI, and BDNF within both intervention groups. The median change scores of STREAM, MBI, and BDNF reported P ≥ 0.05 when compared between the groups. Both the groups had significant recovery post-intervention designed based on ASAP, about impairment mitigation, pursuing skilled movement leading to significant functional gains. Appropriate timing along with optimal dosage became an active ingredient in functional recovery in acute stroke subjects. The distributed practice might have added effect of spacing, resulting in easier learning and accuracy of skills. The study reveals that distributed practice can be part of regular clinical practice to enhance functional recovery in acute stroke rehabilitation.
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CiteScore
2.10
自引率
0.00%
发文量
129
审稿时长
22 weeks
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