Journal of Taiwan Occupational Therapy Research and Practice
目的：本研究以臨床評估來檢測「修正之侷限－誘發運動治療(modified Constraint-Induced Movement Therapy, mCIMT)」之療效，mCIMT採用縮短每天治療與侷限時間的療程，療效評估包括不同的健康層面。方法：二十六位單側偏癱的中風患者參與本研究。13位每天接受2小時患側手訓練及6小時健側手侷限，持續3週者，為mCIMT組。其他接受3週傳統治療療程者，為傳統治療組。在治療前後，利用臨床測驗以評估臨床行為表現。結果：經過治療後，mCIMT組在肌肉張力、動作恢復、日常生活執行能力、使用量、動作品質及精細動作、生活品質的部分向度恢復均較傳統治療組好。結論：mCIMT可改善臨床行為表現。接受mCIMT的個案比傳統治療組有更佳的事先計劃，動作變得更有效率、更流暢。這些結果如同傳統的CIMT，mCIMT亦有益於單側偏癱患者，能改善習得廢用症，增加患側手的使用頻率與動作品質，未來研究可進一步結台運動學分析與功能性磁振造影來進行評估，有助於了解接受mCIMT後的腦部變化與動作行為之間的關聯性。
This study employed a modified CIMT (mCIMT) program by shortening intervention delivered and constraint hours per day, and used clinical measures to examine the effect of mCIMT on various aspects of health. Methods: Twenty-six patients with unilateral hemiparesis after stroke participated in this study and were evaluated pre- and post-intervention by clinical measures. Thirteen patients received 2-hour training for the affected arm and 6-hour constraint for the unaffected arm per day for 3 weeks and were served as the mCIMT group. The other patients received 3-week conventional treatment program and were served as the control group. Results: The mCIMT group also produced significantly better motor outcomes including muscle tone, motor recovery, performance of activities of daily living, amount of use, quality of movement, and some aspects of quality of life after training than those in the conventional group. Conclusion: The mCIMT involving shorter intervention and restraint periods per day still improved movement performance. Patients with hemiparesis might benefit from mCIMT which could overcome learned nonuse phenomenon, and increase the amount of use end quality of movement of the affected hand. Further research may investigate the relation between change of brain and clinical behavior after mCIMT by combining kinematics and functional Magnetic Resonance Imaging.