透過您的圖書館登入
IP:174.129.190.10
  • 期刊

現代任務導向中風復健途徑之文獻回顧

Contemporary Task-Directed Approach to StrokeRehabilitation: A Literature Review

摘要


目的:任務取向/相關訓練與特定任務訓練常用於訓練中風患者的動作復健,本文回顧各訓練方式,並整理相關實證研究加以分析,以充實實證基礎,並提供臨床運用參考。本文採系統性文獻回顧,經由PubMed、Medline、Scopus及ProQuest等資料庫中搜索2009年7月之前和進行任務取向訓練、任務相關訓練,或特定任務訓練相關之療效研究。結果:統整相關文獻,共29篇文獻符合納入標準。其中19篇歸類於任務取向/相關訓練、10篇為特定任務訓練。兩大類的訓練模式皆可運用於上肢或下肢的動作訓練,但由於治療方法的不同,在動作恢復上也呈現差異。總體而言,任務取向/相關訓練及特定任務訓練皆可提升患者的動作表現。無論上肢或下肢任務取向/相關訓練,動作功能及動作能力上,均呈現治療成效,但特定任務訓練的成效主要在於上肢動作能力與大腦活化,在功能表現之療效較不明顯。現有研究較少針對日常生活功能及生活品質進行成果評估,因此對這些層面的成效仍不清楚。近年所發展出來的任務取向/相關訓練合併療法,則能強化單一任務訓練之療效,提升了患者的日常生活功能及動作恢復。結論:不同的訓練方式可促進患者的動作回復,但任務取向/相關訓練相較於特定任務訓練,較能增進動作功能的進步;而特定任務訓練是針對特定動作來訓練(例如:上肢的目標導向伸臂動作),成效雖以中風後偏癱上肢的動作改善為主,但適用之對象可能更廣泛。未來研究可使用追蹤評量進一步針對任務訓練對日常生活功能及生活品質之影響進行探討。

並列摘要


Objective: Task-oriented, task-related and task-specific trainings are often used to reduce motor impairments in stroke patients. The purpose of this article was to review the concepts of these training approaches and to review relevant empirical studies that examined the efficacy of the treatment. The present systematic review searched for original efficacy studies dated before July 2009 in the Pubmed, Medline, Scopus and ProQuest databases. The studies included in this review need to be relevant to task-oriented, task-related, or task-specific training programs. Results: Twnety-nine eligible studies were located. Nineteen of these reports were categorized as studies of task-oriented or task-related training, and 10 involved task-specific training. These approaches were applied to the training of both upper and lower extremities in the studies. Treatment outcomes varied depending on study characteristics, including treatment methods and outcome measures. Overall, both the task-oriented/task-related and task-specific training improved functional outcomes. The task-oriented and task-related training showed salient effects on motor abilities and motor function in either the upper or the lower extremity. In contrast, the task-specific training conferred benefits on motor ability of the upper extremity and brain activation, but the effects on motor function were limited. The efficacy of the treatments on daily function and quality of life was not clear due to the limited number of investigations employing these outcome measures. The combined task-oriented or task-related training and other therapies enhanced the treatment effects on motor performance and daily function in comparison with a single training approach. Conclusion: This review showed evidence in support of the efficacy of task-oriented and task-related training on motor function. Task- specific training may improve specific movement components (e.g., upper-limb reaching movements). Although the effects were limited to improving motor abilities of the hemiplegic upper extremity, the task-specific training could be applied to a variety of clinical populations. Further research may be focused on the effects of task training approaches on daily functions and quality of life with follow-up study.

延伸閱讀