PDF(Pubmed)
Abstract：
OBJECTIVE: To identify and evaluate 3 training variables of motor training programmes involving people with a cervical spinal cord injury: i.e. motor training strategies, therapy dosage, and persons\' motivation for arm-hand functioning in subacute and chronic phases.
METHODS: PubMed, Cochrane, CINAHL, EMBASE, and DARE databases were searched for active arm-hand motor training programmes. Two independent reviewers assessed methodological quality. Pre-post effect sizes were calculated using Hedge\'s g, and mean effect sizes were calculated to compare outcomes on the International Classification of Functioning, Disability, and Health levels of function and activity.
RESULTS: Twelve training programmes integrated mainly skill training alone or combined with strength and/or endurance training. Task-oriented training components included: multiple movement planes, functional movements, clear functional goals, and bimanual practice. Training duration of 8 weeks was common. Quantitative analyses of 8 training programmes showed an overall small effect (0.34) on function level and an overall moderate effect (0.55) on activity level. In depth-analysis of activity level showed moderate effects of skill training only (0.55) or combined with strength and endurance training (0.53). Moderate effects (0.53-0.60) were found for integrating functional movements, clear functional goals, real-life object manipulation, multiple movement planes, total skill practice, context-specific environment, exercise variety, and bimanual practice. Training of minimum 8 weeks showed a moderate effect (0.60-0.69).
CONCLUSIONS: Based on limited studies, arm-hand functioning aiming to improve activity level can be improved using skill training with at least 8 task-oriented training components, additional strength and endurance training, with a minimum training duration of 8 weeks.
METHODS: PubMed, Cochrane, CINAHL, EMBASE, and DARE databases were searched for active arm-hand motor training programmes. Two independent reviewers assessed methodological quality. Pre-post effect sizes were calculated using Hedge\'s g, and mean effect sizes were calculated to compare outcomes on the International Classification of Functioning, Disability, and Health levels of function and activity.
RESULTS: Twelve training programmes integrated mainly skill training alone or combined with strength and/or endurance training. Task-oriented training components included: multiple movement planes, functional movements, clear functional goals, and bimanual practice. Training duration of 8 weeks was common. Quantitative analyses of 8 training programmes showed an overall small effect (0.34) on function level and an overall moderate effect (0.55) on activity level. In depth-analysis of activity level showed moderate effects of skill training only (0.55) or combined with strength and endurance training (0.53). Moderate effects (0.53-0.60) were found for integrating functional movements, clear functional goals, real-life object manipulation, multiple movement planes, total skill practice, context-specific environment, exercise variety, and bimanual practice. Training of minimum 8 weeks showed a moderate effect (0.60-0.69).
CONCLUSIONS: Based on limited studies, arm-hand functioning aiming to improve activity level can be improved using skill training with at least 8 task-oriented training components, additional strength and endurance training, with a minimum training duration of 8 weeks.
摘要：
目的：确定和评估涉及颈脊髓损伤患者的运动训练计划的3个训练变量：即运动训练策略，治疗剂量,和人在亚急性和慢性阶段手臂功能的动机。
方法：PubMed，科克伦,CINAHL,EMBASE,在DARE数据库中搜索了主动手臂手运动训练计划。两名独立审稿人评估了方法学质量。pre-posteffectsizewerecalculatedusingHedge\sg,并计算平均效应大小，以比较国际功能分类的结果，残疾,以及功能和活动的健康水平。
结果：十二项训练计划主要是单独的技能训练或与力量和/或耐力训练相结合。面向任务的培训组件包括：多个运动平面，功能性运动，明确的功能目标，和两手练习。训练时间通常为8周。对8项培训计划的定量分析显示，对功能水平的总体影响很小（0.34），对活动水平的总体影响中等（0.55）。对活动水平的深入分析显示，仅技能训练（0.55）或结合力量和耐力训练（0.53）的中等效果。中等效应（0.53-0.60）被发现用于整合功能运动，明确的功能目标，现实生活中的对象操纵，多个运动平面，总技能练习，特定于上下文的环境，锻炼品种，和两手练习。最少8周的训练显示出中等效果（0.60-0.69）。
结论：基于有限的研究，旨在提高活动水平的手臂功能可以通过具有至少8个面向任务的训练组件的技能训练来提高，额外的力量和耐力训练，最低训练时间为8周。
方法：PubMed，科克伦,CINAHL,EMBASE,在DARE数据库中搜索了主动手臂手运动训练计划。两名独立审稿人评估了方法学质量。pre-posteffectsizewerecalculatedusingHedge\sg,并计算平均效应大小，以比较国际功能分类的结果，残疾,以及功能和活动的健康水平。
结果：十二项训练计划主要是单独的技能训练或与力量和/或耐力训练相结合。面向任务的培训组件包括：多个运动平面，功能性运动，明确的功能目标，和两手练习。训练时间通常为8周。对8项培训计划的定量分析显示，对功能水平的总体影响很小（0.34），对活动水平的总体影响中等（0.55）。对活动水平的深入分析显示，仅技能训练（0.55）或结合力量和耐力训练（0.53）的中等效果。中等效应（0.53-0.60）被发现用于整合功能运动，明确的功能目标，现实生活中的对象操纵，多个运动平面，总技能练习，特定于上下文的环境，锻炼品种，和两手练习。最少8周的训练显示出中等效果（0.60-0.69）。
结论：基于有限的研究，旨在提高活动水平的手臂功能可以通过具有至少8个面向任务的训练组件的技能训练来提高，额外的力量和耐力训练，最低训练时间为8周。
