Bonan Isabelle V, Yelnik Alain P, Colle Florence M, Michaud Carole, Normand Emanuelle, Panigot Benedicte, Roth Philippe, Guichard Jean P, Vicaut Eric
Department of Physical Medicine and Rehabilitation, GH Lariboissiere-F. Widal, Paris, France.
Arch Phys Med Rehabil. 2004 Feb;85(2):274-8. doi: 10.1016/j.apmr.2003.06.016.
To test the hypothesis that balance rehabilitation with visual cue deprivation improves balance more effectively than rehabilitation with free vision.
Single-blind, randomized controlled trial.
Public rehabilitation center in France.
Twenty patients with hemiplegia after a single-hemisphere stroke that occurred at least 12 months before the study.
Patients were randomly assigned to 1 of 2 balance rehabilitation programs-with and without visual cue deprivation. In all other respects, the programs were identical. Each lasted for 1 hour and was implemented 5 days a week for 4 weeks. All patients completed the program. Mean outcome measures Balance under 6 sensory conditions was assessed by computerized dynamic posturography (EquiTest), gait velocity, timed stair climbing, and self-assessment of ease of gait before and after program completion.
After completing the program, balance, gait velocity, and self-assessment of gait improved significantly in all patients. The improvements in gait velocity (P= .03) and timed stair climbing (P= .01) correlated significantly with improved balance. Balance improved more in the vision-deprived group than in the free-vision group.
Balance improved more after rehabilitation with visual deprivation than with free vision. Visual overuse may be a compensatory strategy for coping with initial imbalance exacerbated by traditional rehabilitation.
检验如下假设，即与视觉线索剥夺相结合的平衡康复训练比自由视觉条件下的康复训练能更有效地改善平衡能力。
单盲随机对照试验。
法国的一家公共康复中心。
20名单半球卒中后偏瘫患者，卒中发生时间至少在研究前12个月。
患者被随机分配到两个平衡康复训练项目中的一个，一个有视觉线索剥夺，另一个没有。在所有其他方面，两个项目相同。每个项目持续1小时，每周实施5天，共4周。所有患者均完成了该项目。主要结局指标 通过计算机化动态姿势描记法（EquiTest）评估6种感觉条件下的平衡能力、步态速度、定时爬楼梯能力，以及项目完成前后的步态舒适度自我评估。
完成项目后，所有患者的平衡能力、步态速度和步态自我评估均有显著改善。步态速度的改善（P = .03）和定时爬楼梯能力的改善（P = .01）与平衡能力的改善显著相关。视觉剥夺组的平衡能力改善比自由视觉组更多。
与自由视觉相比，视觉剥夺康复训练后平衡能力改善更明显。视觉过度使用可能是一种补偿策略，用于应对传统康复训练加剧的初始失衡。
