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Hyperbaric Oxygen and Focused Rehabilitation Program: A Feasibility Study in Improving Upper Limb Motor Function After Stroke.
Applied Physiology, Nutrition, and Metabolism ( IF 2.4 ) Pub Date : 2020-06-23 , DOI: 10.1139/apnm-2020-0124 S Schiavo 1 , D Richardson 2 , D Santa Mina 3, 4, 5 , S Buryk-Iggers 3 , J Uehling 1 , J Carroll 1 , H Clarke 1 , C Djaiani 1 , M Gershinsky 1 , R Katznelson 1
Applied Physiology, Nutrition, and Metabolism ( IF 2.4 ) Pub Date : 2020-06-23 , DOI: 10.1139/apnm-2020-0124 S Schiavo 1 , D Richardson 2 , D Santa Mina 3, 4, 5 , S Buryk-Iggers 3 , J Uehling 1 , J Carroll 1 , H Clarke 1 , C Djaiani 1 , M Gershinsky 1 , R Katznelson 1
Affiliation
Applied Physiology, Nutrition, and Metabolism, Ahead of Print.
Neuroplasticity and recovery after stroke can be enhanced by a rehabilitation program pertinent to upper limb motor function exercise and mental imagery (EMI) as well as hyperbaric oxygen therapy (HBOT). We assessed feasibility and safety of the combined approach utilizing both HBOT and EMI, and to derive preliminary estimates of its efficacy. In this randomized controlled trial, 27 patients with upper extremity hemiparesis at 3–48 months after stroke were randomized to receive either a complementary rehabilitation program of HBOT-EMI (intervention group), or EMI alone (control group). Feasibility and safety were assessed as total session attendance, duration of sessions, attrition rates, missing data, and intervention-related adverse events. Secondary clinical outcomes were assessed with both objective tools and self-reported measures at baseline, 8 weeks (end of treatment), and 12-weeks follow-up. Session attendance, duration, and attrition rate did not differ between the groups; there were no serious adverse events. Compared with baseline, there were significant sustained improvements of objective and subjective outcomes’ measures in the intervention group, and a single improvement in an objective measure in the control group. Between-group outcome comparisons were not statistically significant. This study demonstrated that the combination HBOT-EMI was a safe and feasible approach in patients recovering from chronic stroke. There were also trends for improved motor function of the affected upper limb after the treatments. ClinicalTrials.gov registration no.: NCT02666469. Novelty HBOT combined with an upper limb exercise and mental imagery rehabilitation program is feasible and safe in chronic stroke patients. This combined approach showed trends for improved functional recovery.
中文翻译：
高压氧和集中康复计划：改善中风后上肢运动功能的可行性研究。
应用生理学、营养学和代谢，提前出版。
中风后的神经可塑性和恢复可以通过与上肢运动功能锻炼和心理意象 (EMI) 以及高压氧治疗 (HBOT) 相关的康复计划来增强。我们评估了同时使用 HBOT 和 EMI 的组合方法的可行性和安全性，并对其功效进行了初步估计。在这项随机对照试验中，27 名卒中后 3-48 个月出现上肢偏瘫的患者随机接受 HBOT-EMI 的补充康复计划（干预组）或单独的 EMI（对照组）。可行性和安全性被评估为会议总出席率、会议持续时间、流失率、缺失数据和与干预相关的不良事件。次要临床结果在基线、8 周（治疗结束）和 12 周随访时使用客观工具和自我报告的措施进行评估。各组之间的会议出席率、持续时间和流失率没有差异；没有严重的不良事件。与基线相比，干预组的客观和主观结果指标有显着的持续改善，而对照组的客观指标有单一改善。组间结果比较无统计学意义。该研究表明，HBOT-EMI 联合治疗对慢性中风康复患者是一种安全可行的方法。治疗后受影响上肢的运动功能也有改善的趋势。ClinicalTrials.gov 注册号：NCT02666469。新颖的 HBOT 结合上肢运动和心理意象康复计划对慢性中风患者是可行和安全的。这种组合方法显示出改善功能恢复的趋势。
更新日期：2020-06-23
Neuroplasticity and recovery after stroke can be enhanced by a rehabilitation program pertinent to upper limb motor function exercise and mental imagery (EMI) as well as hyperbaric oxygen therapy (HBOT). We assessed feasibility and safety of the combined approach utilizing both HBOT and EMI, and to derive preliminary estimates of its efficacy. In this randomized controlled trial, 27 patients with upper extremity hemiparesis at 3–48 months after stroke were randomized to receive either a complementary rehabilitation program of HBOT-EMI (intervention group), or EMI alone (control group). Feasibility and safety were assessed as total session attendance, duration of sessions, attrition rates, missing data, and intervention-related adverse events. Secondary clinical outcomes were assessed with both objective tools and self-reported measures at baseline, 8 weeks (end of treatment), and 12-weeks follow-up. Session attendance, duration, and attrition rate did not differ between the groups; there were no serious adverse events. Compared with baseline, there were significant sustained improvements of objective and subjective outcomes’ measures in the intervention group, and a single improvement in an objective measure in the control group. Between-group outcome comparisons were not statistically significant. This study demonstrated that the combination HBOT-EMI was a safe and feasible approach in patients recovering from chronic stroke. There were also trends for improved motor function of the affected upper limb after the treatments. ClinicalTrials.gov registration no.: NCT02666469. Novelty HBOT combined with an upper limb exercise and mental imagery rehabilitation program is feasible and safe in chronic stroke patients. This combined approach showed trends for improved functional recovery.
中文翻译：
高压氧和集中康复计划：改善中风后上肢运动功能的可行性研究。
应用生理学、营养学和代谢，提前出版。
中风后的神经可塑性和恢复可以通过与上肢运动功能锻炼和心理意象 (EMI) 以及高压氧治疗 (HBOT) 相关的康复计划来增强。我们评估了同时使用 HBOT 和 EMI 的组合方法的可行性和安全性，并对其功效进行了初步估计。在这项随机对照试验中，27 名卒中后 3-48 个月出现上肢偏瘫的患者随机接受 HBOT-EMI 的补充康复计划（干预组）或单独的 EMI（对照组）。可行性和安全性被评估为会议总出席率、会议持续时间、流失率、缺失数据和与干预相关的不良事件。次要临床结果在基线、8 周（治疗结束）和 12 周随访时使用客观工具和自我报告的措施进行评估。各组之间的会议出席率、持续时间和流失率没有差异；没有严重的不良事件。与基线相比，干预组的客观和主观结果指标有显着的持续改善，而对照组的客观指标有单一改善。组间结果比较无统计学意义。该研究表明，HBOT-EMI 联合治疗对慢性中风康复患者是一种安全可行的方法。治疗后受影响上肢的运动功能也有改善的趋势。ClinicalTrials.gov 注册号：NCT02666469。新颖的 HBOT 结合上肢运动和心理意象康复计划对慢性中风患者是可行和安全的。这种组合方法显示出改善功能恢复的趋势。
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