限制－誘發動作治療於中風病人復健之療效

限制－誘發動作治療(constraint-induced movement therapy)為一種可用於中樞神經復健的治療方式，尤其是中風病人。它主要是使用－限制物，將病人的健側肢體侷限，以控制其自由活動時間，並讓病人的患側肢體接受密集性、有計畫性的復健治療，利用如此的治療方式，讓病人克服因中風後造成的失能。限制－誘發動作治療有兩大理論基礎：「習得廢用」(learned-non-use)現象對動作失能的惡化效應，以及大腦皮質重組(cortical reorganization)對神經功能恢復的重要。本文回顧運用這樣的機制而發展出短時間內高密度的介入，並達到增進患側動作能力及生活功能成效的實證文獻。影響治療成效的因素當中，除了患者本身的健康狀況之外，治療介入的時間點也是影響療效的要因。回顧近年之文獻，目前學者大多建議使用於慢性期病人，可兼顧安全、經濟(cost-effectiveness)以及治療成效的考量。針對急性期以及亞急性期病患之成效，目前的文獻中受試者數量較少，以及實驗數據較缺乏，未來尚有很大的探研空間。

關鍵字

復健；限制－誘發動作治療；習得廢用；大腦皮質重組

並列摘要

Constraint-induced movement therapy is a therapeutic technique used for central nervous system rehabilitation, especially for stroke. Movements of the less affected limb were constrained with a restraint mitt. The affected limb received frequent, well-planned rehabilitative movement therapy. Such therapeutic regimen was used to improve motor and functional disability after stroke. Constraint-induced movement therapy was developed to overcome learned non-use and promote cortical reorganization. This paper reviewed the mechanisms and treatment effects. Among the factors that may affect treatment success, the time that intervention was initiated is one of the important factors. The published clinical trials reported effects of the therapy in patients with chronic as well as subacute stroke. Further research based on larger samples of patients with acute and subacute stroke is needed.

並列關鍵字

rehabilitation ； constraint-induced movement therapy ； learned non-use ； cortical reorganization

國際替代計量

限制－誘發動作治療於中風病人復健之療效

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