Focal Hand Dystonia: Effectiveness of a Home Program of Fitness and Learning-based Sensorimotor and Memory Training

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• 作者：Nancy N. Byl ; Eve Serena Archer ; Alison McKenzie
• 刊名：Journal of Hand Therapy
• 出版年：2009
• 出版时间：April-June 2009
• 年：2009
• 卷：22
• 期：2
• 页码：183-198
• 全文大小：378 K

文摘

Study Design

This was a pre post test design.

Introduction

Retraining the brain is one approach to remediate movement dysfunction resulting from task specific focal hand dystonia (FHD_TSP).

Purpose

Document change in task specific performance (TSP) for patients with FHD_TSP after 8 weeks of comprehensive home training (fitness activities, task practice, learning based memory and sensorimotor training).

Methods

Thirteen subjects were admitted and evaluated at baseline, immediately and 6 months post treatment for task specific performance, functional independence, sensory discrimination, fine motor speed and strength. In Phase I, 10 subjects were randomly assigned to home training alone or supervised practice prior to initiating the home training. In phase II, 2 subjects crossed over and 3 new subjects were added (18 hands). The intent to treat model was followed. Outcomes were summarized by median, effect size, and proportion improving with nonparametric analysis for significance.

Results

Immediately post-intervention, TSP, sensory discrimination, and fine motor speed improved 60-80 % (p<0.00l respectively). Functional independence and strength improved by 50 % . Eleven subjects (16 hands) were re-evaluated at 6 months; all but one subject reported a return to work. Task-specific performance was scored 84-90 % . Supervised practice was associated with greater compliance and greater gains in performance.

Conclusions

Progressive task practice plus learning based memory and sensorimotor training can improve TSP in patients with FHD_TSP. Compliance with home training is enhanced when initiated with supervised practice.

Level of Evidence

4.