Alptekin N, Gok H, Geler-Kulcu D, Dincer G
Department of Physical Medicine and Rehabilitation, Ankara University, Faculty of Medicine, Ankara, Turkey.
Clin Rehabil. 2008 Oct-Nov;22(10-11):922-30. doi: 10.1177/0269215508090673.
To investigate whether the addition of a kinaesthetic ability training device could enhance the effect of a conventional rehabilitation programme on balance and mobility in hemiparetic patients late after stroke.
Randomized, controlled, assessor-blinded trial.
The rehabilitation ward of a university hospital. Thirty hemiparetic patients (mean age (SD) of 57.4 (8.1) years) late after stroke (mean time since stroke (SD) 545.2 (99.9) days) were assigned randomly to an experimental or a control group.
The control group (n = 15) participated in a conventional rehabilitation programme. The experimental group (n = 15) participated in balance training with a kinaesthetic ability training device in addition to a conventional rehabilitation programme for four weeks, five days a week.
Kinaesthetic ability training static and dynamic balance indices, balance and lower extremity subscores of the Fugl-Meyer Stroke Assessment Instrument (FMA), total motor and locomotor subitem scores of the Functional Independence Measure (FIM) were evaluated at baseline and after treatment.
The experimental group had greater improvement in measures of balance including static (P = 0.045) and dynamic balance index (P = 0.001) and FMA balance score (P = 0.001) than the control group. No between-group differences were detected in subscore of FMA, total motor and locomotor subscores of FIM. There were significant improvements in balance subscores of FMA, static and dynamic balance indexes in the experimental group and in sub-item scores of FIM and lower extremity scores of FMA in both groups.
Kinaesthetic ability training in addition to a conventional rehabilitation programme is effective in improving balance late after stroke. However, this improvement is not reflected in individual functional status.
探讨增加一种动觉能力训练设备是否能增强传统康复方案对中风后晚期偏瘫患者平衡能力和运动能力的影响。
随机、对照、评估者盲法试验。
一所大学医院的康复病房。30例中风后晚期偏瘫患者(平均年龄(标准差)为57.4(8.1)岁,中风后平均时间(标准差)为545.2(99.9)天)被随机分为实验组和对照组。
对照组(n = 15)参加传统康复方案。实验组(n = 15)除参加传统康复方案外,还使用动觉能力训练设备进行平衡训练,为期四周,每周五天。
在基线和治疗后评估动觉能力训练的静态和动态平衡指标、Fugl-Meyer中风评估量表(FMA)的平衡和下肢子评分、功能独立性测量(FIM)的总运动和运动子项评分。
实验组在平衡指标方面的改善程度大于对照组,包括静态平衡(P = 0.045)、动态平衡指数(P = 0.001)和FMA平衡评分(P = 0.001)。FMA子评分、FIM的总运动和运动子评分在两组之间未检测到差异。实验组FMA平衡子评分、静态和动态平衡指数以及两组的FIM子项评分和FMA下肢评分均有显著改善。
除传统康复方案外,动觉能力训练对改善中风后晚期的平衡能力有效。然而,这种改善并未体现在个体功能状态上。