TREATMENT FOR EXCESS MOTOR DISABILITY IN THE AGED

老年人过度运动障碍的治疗

• 批准号: 2025911
• 负责人: Edward Taub
• 金额: $ 27.38万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-12-09 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2025911
• 关键词: age difference; aging; behavioral /social science research tag; clinical research; functional ability; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; immobilization of body part; limb movement; magnetic resonance imaging; outcomes research; person with disability; physical therapy; rehabilitation; restraint; stroke

In this laboratory we have developed a new set of techniques that preliminary studies suggest can substantially reduce the incapacitating motor deficit of many elderly stroke patients and lessen their dependence. The techniques involve "constraint-induced" (CI) facilitation of impaired movement and include prolonged motor restriction of the unaffected upper extremity by a sling while at the same time training the affected upper limb. Initial results indicate that old age, per se, is not an important factor in limiting the final level of motor recovery attainable. Limitations of the work previously carried out in this laboratory were the small sample size and a control intervention that was not equal in credibility to the experimental intervention. Aim 1 of the proposed research will be to address these two issues. The sample size will be increased. In addition, the interventions employed in two physical therapy comparison groups have been redesigned so that they will be equal in credibility to that employed with the CI group. Aim 2 of the project is to determine whether aging is a factor in the speed or extent to which the motor impairment of the upper extremity in chronic stroke patients can be reduced by CI techniques. Aim 3 of the study is to ascertain through the use of magnetic resonance imaging whether there is some commonality in the location or extent of the lesions that characterize patients who benefit most from use of CI techniques. The goal of Aim 4 is to assess in a controlled study whether either the intensive or conventional physical therapy we propose to employ is effective in improving the upper extremity motor status of chronic stroke patients. The research team is interdisciplinary and includes three psychologists (with the emphasis of different individuals being in rehabilitation and motor control, statistics and gerontology), a neurologist and two physical therapists. The experimental design will involve 80 subjects randomly assigned to four groups (with blocking based on age). One group will receive movement restriction of the impaired upper extremity for a period of two weeks and training of the unaffected upper extremity. These results will be compared with those of a group of subjects receiving intensive physical therapy, a group of subjects receiving conventional physical therapy and a group of subjects on a waiting list. Each group of 20 will have equal numbers of persons with left - and right - brain strokes. The motor function, amount of limb use and range of motion of these individuals will be assessed before and after intervention and during followup, both in the laboratory and in the life situation.

在这个实验室中，我们开发了一套新的技术 初步研究表明，可以大大减少 丧失能力 许多老年人中风患者的运动不足并减少 依赖。 这些技术涉及“约束诱导的”（CI） 促进运动受损并包括长时间电动机 限制 吊索不受影响的上肢 训练受影响的上肢。 初始结果表明 晚年， 本身，不是限制最终水平的重要因素 发动机 恢复可实现。 以前携带的工作的局限性 出去 该实验室是小样本量和对照 干涉 这与实验干预的信誉并不相等。 目的 拟议的研究中有1个将是解决这两个问题。 这 样本量将增加。 另外，干预措施 雇用 在两个物理疗法比较组中，已经重新设计了 那 他们的信誉与CI的信誉相同 团体。 该项目的目标2是确定衰老是否是一个因素 这 上部运动障碍的速度或程度 四肢 CI技术可以降低慢性中风患者。 目标3 这 研究是通过使用磁共振成像来确定 是否有一些共同点在 用使用CI受益最大的患者的病变 技术。 目标4的目标是在对照研究中评估 无论 我们建议要进行的密集或常规物理疗法 雇员有效地改善上肢电动机状态 的 慢性中风患者。 研究小组是跨学科的 和 包括三位心理学家（强调不同的心理学家 个人 处于康复和运动控制，统计和 老年学）， 神经科医生和两名物理治疗师。 实验设计 将要 涉及80名随机分配给四组的受试者（阻止 基于 年龄）。 一组将受到运动限制 受损 上肢持续了两个星期，并训练 不受影响 上肢。 这些结果将与A的结果进行比较 一组 接受强化物理疗法的受试者，一组受试者 接受常规的物理疗法和一组受试者 一个 等待清单。 每组20组的人数相等 和 左 - 右 - 大脑触诊。 运动功能，数量 肢体使用 这些人的运动范围将在之前进行评估 和 干预后和随访期间，包括在实验室和 在 生活状况。