Preliminary study of the effect of low-intensity home-based physical therapy in chronic stroke patients

This study was a preliminary examination of the effect of low-intensity home-based physical therapy on the performance of activities of daily living (ADL) and motor function in patients more than 1 year after stroke. Twenty patients were recruited from a community stroke register in Nan-Tou County, Taiwan, to a randomized, crossover trial comparing intervention by a physical therapist immediately after entry into the trial (Group I) or after a delay of 10 weeks (Group II). The intervention consisted of home-based physical therapy once a week for 10 weeks. The Barthel Index (BI) and Stroke Rehabilitation Assessment of Movement (STREAM) were used as standard measures for ADL and motor function. At the first follow-up assessment at 11 weeks, Group I showed greater improvement in lower limb motor function than Group II. At the second follow-up assessment at 22 weeks, Group II showed improvement while Group I had declined. At 22 weeks, the motor function of upper limbs, mobility, and ADL performance in Group II had improved slightly more than in Group I, but the between-group differences were not significant. It appears that low-intensity home-based physical therapy can improve lower limb motor function in chronic stroke survivors. Further studies will be needed to confirm these findings.
本研究的目的是初步探討非密集性居家物理治療對於改善發病1年以上慢性期中風患者日常生活活動和動作功能的療效。以登錄南投縣政府身心障礙手冊資料庫中20位社區個案為研究對象，採用隨機分組交叉進行的研究設計，將受試者隨機分為立即和延後治療兩組。立即治療組（第一組）首先接受由物理治療師執行的每週1次且持續10週的居家物理治療計畫；延後治療組（第二組）開始時不接受治療，10週以後才接受居家物理治療計畫。以巴氏日常生活量表和中風復健動作評估量表作為評估患者日常生活活動和動作功能的測量工具。在第11週的第一次追蹤評估，第一組在動作評估量表下肢動作功能部份的得分比第二組有明顯的進步；在第22週的第二次追蹤評估，第二組在下肢動作功能部份的得分有明顯的進步，第一組在下肢動作功能部份的得分反而退步。然而，兩組在巴氏日常生活量表及中風復健動作評估量表有關上肢動作功能和移位部份的進步量的差異並未達統計意義。本研究結果顯示，非密集性居家物理治療計畫對於中風患者下肢動作功能的進步有特定的療效。這些結果需要更進一步的研究加以證實。 Copyright © 2004 Elsevier. All rights reserved.