运动想象引物可改善中风后患者的活动和功能障碍结果，但其他类型引物的效果尚不明确：系统综述。

IF 9.7 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy Pub Date : 2024-10-01 DOI:10.1016/j.jphys.2024.08.007

Simone Dorsch , Vaughan Nicholson , Emilia Roman , Emma Fanayan , Sakina Chagpar

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引用次数: 0

摘要

问题在脑卒中康复中，与单纯的特定任务练习相比，在特定任务练习之前添加非刺激性引物对活动和运动损伤结果的影响如何？参与者：成年中风幸存者：干预：实验组在进行特定任务练习前完成非刺激性引导干预。启蒙干预包括：运动想象；动作观察；运动想象和动作观察相结合；镜像疗法；基于动作的启蒙；基于有氧运动的启蒙。对照组仅完成特定任务练习：结果：上下肢活动和运动障碍：本系统综述共纳入了 24 项试验，涉及 803 名参与者。20项试验被纳入活动结果的荟萃分析，11项试验被纳入损伤结果的荟萃分析。四项试验研究了在特定任务练习之前进行运动想象对活动结果的影响（SMD 0.48，95% CI 0.13 至 0.82）。三项试验研究了在特定任务练习前进行运动想象对运动损伤结果的影响（SMD 0.51，95% CI 0.12 至 0.89）。九项试验研究了在特定任务练习前进行动作观察引导对活动结果的影响（SMD 0.18，95% CI -0.06-0.41）。两项试验研究了在特定任务练习前进行动作引导对活动结果的影响（SMD -0.11，95% CI -0.64-0.42）。三项试验研究了在特定任务练习前进行有氧运动引导对活动结果的影响（SMD 0.30，95% CI -0.19-0.80）。证据质量为中低水平：结论：在脑卒中康复中，在特定任务训练前进行运动想象对活动和运动障碍结果的影响由小到大。在特定任务训练前进行动作观察引导对活动结果的影响可忽略不计，甚至很小。以运动为基础和以有氧运动为基础的引导对结果没有任何明显的影响：注册号：CRD42020093519。

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Motor imagery priming improves activity and impairment outcomes in people after stroke but the effects of other types of priming are unclear: a systematic review

Question

In stroke rehabilitation, what is the effect of adding non-stimulation-based priming prior to task-specific practice on activity and motor impairment outcomes compared with task-specific practice alone?

Design

Systematic review with meta-analysis.

Participants

Adult stroke survivors.

Intervention

The experimental groups completed a non-stimulation priming intervention prior to task-specific practice. The priming interventions were: motor imagery; action observation; combined motor imagery and action observation; mirror therapy; movement-based priming; and aerobic exercise-based priming. The control groups completed task-specific practice alone.

Outcome measures

Upper and lower limb activity and motor impairment.

Results

Twenty-four trials involving 803 participants were included in this systematic review. Twenty trials were included in the meta-analyses of activity outcomes and 11 trials in the meta-analyses of impairment outcomes. Four trials examined the effect of motor imagery priming prior to task-specific practice on activity outcomes (SMD 0.48, 95% CI 0.13 to 0.82). Three trials examined the effect of motor imagery priming prior to task-specific practice on motor impairment outcomes (SMD 0.51, 95% CI 0.12 to 0.89). Nine trials examined the effect of action observation priming prior to task-specific practice on activity outcomes (SMD 0.18, 95% CI –0.06 to 0.41). Two trials examined the effect of movement-based priming prior to task-specific practice on activity outcomes (SMD –0.11, 95% CI –0.64 to 0.42). Three trials examined the effect of aerobic exercise priming prior to task-specific practice on activity outcomes (SMD 0.30, 95% CI –0.19 to 0.80). The quality of the evidence was low to moderate.

Conclusion

In stroke rehabilitation, motor imagery priming implemented prior to task-specific training has a very small to large effect on activity and motor impairment outcomes. Action observation priming implemented prior to task-specific training has a negligible to small effect on activity outcomes. Movement-based and aerobic exercise-based priming do not have any clear effect on outcomes.

Registration

CRD42020093519.

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来源期刊

Journal of Physiotherapy ORTHOPEDICS-REHABILITATION

CiteScore

11.40

自引率

7.40%

发文量

审稿时长

72 days

期刊介绍： The Journal of Physiotherapy is the official journal of the Australian Physiotherapy Association. It aims to publish high-quality research with a significant impact on global physiotherapy practice. The journal's vision is to lead the field in supporting clinicians to access, understand, and implement research evidence that will enhance person-centred care. In January 2008, the Journal of Physiotherapy became the first physiotherapy journal to adhere to the ICMJE requirement of registering randomized trials with a recognized Trial Registry. The journal prioritizes systematic reviews, clinical trials, economic analyses, experimental studies, qualitative studies, epidemiological studies, and observational studies. In January 2014, it also became the first core physiotherapy/physical therapy journal to provide free access to editorials and peer-reviewed original research. The Australian Physiotherapy Association extended their support for excellence in physiotherapy practice by sponsoring open access publication of all Journal of Physiotherapy content in 2016. As a result, all past, present, and future journal articles are freely accessible, and there are no author fees for publication.