Page Stephen J, Levine Peter, Teepen Jennah, Hartman Eric C
Department of Rehabilitation Sciences, University of Cincinnati Academic Medical Center, Neuromotor Recovery and Rehabilitation Laboratory, Drake Rehabilitation Center.
Clin Rehabil. 2008 Jul;22(7):610-7. doi: 10.1177/0269215508088987.
To determine efficacy of a bilateral reciprocal training regimen on affected leg impairment and dynamic balance.
Randomized, controlled, single-blinded crossover study.
Outpatient rehabilitation hospital.
Seven patients who experienced stroke >1 year prior to study entry exhibiting affected leg weakness.
Subjects were randomly assigned to receive both of the following in a randomized, sequential order: (a) a resistance-based, reciprocal, affected leg locomotor training protocol using the NuStep apparatus (n = 4) and (b) a home exercise programme (HEP) consisting of self-supervised practice with fractionated joint movements of the lower limb. Each phase of the intervention was performed for 30 minutes each session, three days a week, and conducted over an eight-week period.
Outcomes were evaluated by a blinded rater using the lower extremity scale of the Fugl-Meyer and the Berg Balance Scale.
After HEP participation, subjects showed nominal or no changes on any of the outcome measures. After NuStep participation, patients in both treatment groups showed impairment reductions as shown by the Fugl-Meyer (+4.3; +2.2), and increased balance as shown by the Berg Balance Scale (+4.0; +4.0). These trends were exhibited regardless of group assignment.
Impairment reductions and balance gains may be achieved using a resistance-based, reciprocal upper and lower limb locomotor training protocol.
确定双侧交互训练方案对患侧下肢功能障碍和动态平衡的疗效。
随机对照单盲交叉研究。
门诊康复医院。
7名在研究入组前1年以上发生中风且患侧下肢无力的患者。
受试者被随机分配,以随机顺序接受以下两种干预:(a) 使用NuStep设备进行基于阻力的交互性患侧下肢运动训练方案(n = 4);(b) 一项家庭锻炼计划(HEP),包括下肢关节分步运动的自我监督练习。每个干预阶段每次训练30分钟,每周三天,为期八周。
由一名盲法评估者使用Fugl-Meyer下肢量表和Berg平衡量表评估结果。
参与HEP后,受试者在任何一项观察指标上均无明显变化或无变化。参与NuStep训练后,两个治疗组的患者Fugl-Meyer量表显示功能障碍减轻(分别增加4.3和2.2),Berg平衡量表显示平衡能力提高(分别增加4.0和4.0)。无论分组如何,均呈现这些趋势。
使用基于阻力的上下肢交互运动训练方案可实现功能障碍减轻和平衡能力提高。