Journal of Taiwan Occupational Therapy Research and Practice
半年刊,正常發行
目的:漸進式阻力運動是臨床上針對中風病人常見的一個復健治療方法,它有標準的介入準則。本篇目的在分析歸納漸進式阻力運動療效之實證研究,以供臨床及未來研究之參考。方法:經由PubMed、Medline及Scopus等文獻搜尋引擎,搜尋從2000年至2009年間,以關鍵字為:(strength training or resistive exercise) and (stroke or cerebrovascular accident),篩選條件為以漸進式阻力運動為介入方式的文章,最後共選出10篇符合之文獻。結果:漸進式阻力運動對絕大多數訓練肌肉有增加其力量之效果,尤其對輕度中風病人效果較佳,且訓練成果並無呈現出增加肌肉張力現象之證據;對於身體功能、日常生活及活動參與的療效,不同文章有不一樣的結果,須多考慮其他因子,例如在慢性病人身上,漸進式阻力運動也可增加其功能表現及生活品質。結論:漸進式阻力訓練並沒有明顯增加肌肉張力的情況。它可以增加肌肉力量,甚至可能促使身體功能表現進步、日常生活功能及日常生活參與的改進。漸進式阻力訓練對於慢性輕度的病患較有療效,且8週的訓練即已足夠。未來在提供此種訓練時,亦可合併功能導向的訓練,以達病人康復之最大效果。本文的部份結果僅有少數文獻支持,未來仍須進一步的實證研究來驗證其效益。
Objective: Progressive resistive exercise is one of the common treatments on stroke rehabilitation. The principles of standardized intervention for clinical implementation have been clearly established. It showed standard intervention principle for clinical implementation. The objective of this review is to summarize and analyze the effects of progressive resistive exercise for evidence-based clinical practice. Methods: We searched the key words, (strength training or resistive exercise) and (stroke or cerebrovascular accident), in PubMed, Medline and Scopus databases and retrieved the relevant articles from 2000 to 2009. The included articles had to use the principles of progressive resistive exercise as a guideline for intervention. Results: Progressive resistive exercise could enhance the strength of most target training muscles. Its effects are more salient in mild stroke patients than in moderate or severe patients, and the results didn't show the evidence of progressive resistive exercise would induce abnormal muscle tone. However, the results of progressive resistive exercise on body function, activity of daily living and participation were various depending on other factors. For example, it could enhance functional performance and quality of life when applied in chronic stroke patients. The side effect of back and knee pain should be concerned when this exercise is applied. Conclusion: Progressive resistive exercise did not significantly increase muscle tone. In addition, it improved muscle strength and may enhance body function, daily activities and participation. For mild and chronic patients, progressive resistive exercise has greater effects than sever and acute patients. Eight week training should be enough for significant improvements. Future research may investigate combining resistive exercise training with task-oriented training to optimize intervention effects. However, there were only few studies supporting the results. More empirical studies examining the efficacy are needed.