Dept of Physical Medicine and Rehabilitation, Scientific Institute of Veruno, Fondazione Salvatore Maugeri, IRCCS, Veruno, Italy.
Arch Phys Med Rehabil. 2010 Dec;91(12):1869-77. doi: 10.1016/j.apmr.2010.09.011.
To assess the efficacy of a balance rehabilitation treatment by using both a powered platform on which subjects stand and specific physical exercises (EXs).
Crossover trial.
Physical and rehabilitation medicine department in Italy.
Patients (N=33) with balance disorders (14 vestibular origin, 19 peripheral neuropathy origin).
Patients underwent powered platform then EX treatment (n=17); the other 16 received the same treatments in reverse order. powered platform consisted of balancing on a sinusoidally oscillating powered platform (in anteroposterior and laterolateral directions in separate trials) with eyes open and closed. A physical therapist administered Cawthorne-Cooksey EXs for patients with vestibular disorders and modified Frenkel EXs for patients with neuropathy. Treatment lasted 1 hour a day for 10 consecutive days, except for the weekend.
Body sway area, subjective score of stability, balance and gait scores, and amplitude of head displacement while balancing on the oscillating powered platform were recorded before, (t0) after the first (t1), and after the second treatment (t2), regardless of the powered platform or EX order.
On average, all participants improved balance regardless of the order of treatments, and more so at t2 than t1. Improvement was observed by using instrumental evaluations and balance and gait scales. In both patient groups, powered platform treatment proved to be as effective as EX in improving balance. This effect was stronger in patients with vestibular disorders, independently of order of treatment.
Balance rehabilitation with either EX or powered platform is effective in patients with balance disorders of vestibular or neuropathic origin. These findings point to the value of either or both physical EXs and powered platform in increasing stability and potentially decrease the risk of falling in patients with neuropathy, for whom few results are documented in the literature.
评估使用动力平台和特定物理练习（EX）进行平衡康复治疗的疗效。
交叉试验。
意大利物理和康复医学系。
平衡障碍患者（14 例前庭起源，19 例周围神经病起源）（N=33）。
患者接受动力平台和 EX 治疗（n=17）；其余 16 例按相反顺序接受相同治疗。动力平台由正弦摆动动力平台组成（在单独的试验中进行前后和左右摆动），睁眼和闭眼。物理治疗师为前庭障碍患者提供考克塞-库克西（Cawthorne-Cooksey）EX，为神经病患者提供改良弗伦克尔（Frenkel）EX。治疗每天持续 1 小时，连续 10 天，周末除外。
身体摆动面积、稳定性主观评分、平衡和步态评分，以及在摆动动力平台上平衡时头部位移幅度，记录在治疗前（t0）、第一次治疗后（t1）和第二次治疗后（t2），无论动力平台或 EX 顺序如何。
平均而言，所有参与者的平衡均有所改善，无论治疗顺序如何，t2 时的改善更为明显。仪器评估和平衡与步态量表均显示出改善。在两组患者中，动力平台治疗在改善平衡方面与 EX 一样有效。在治疗顺序独立的情况下，前庭障碍患者的效果更强。
使用 EX 或动力平台进行平衡康复治疗对前庭或神经源性平衡障碍患者有效。这些发现表明，对于文献中记录甚少的神经病变患者，物理 EX 和动力平台的价值在于增加稳定性并降低跌倒风险。
