Bland Daniel C, Zampieri Cris, Damiano Diane L
Functional & Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
Brain Inj. 2011;25(7-8):664-79. doi: 10.3109/02699052.2011.576306. Epub 2011 May 11.
The purpose of this review was to investigate the efficacy or effectiveness of non-aerobic exercise interventions to improve balance and gait in functionally mild-to-moderate individuals with TBI (those who demonstrate the ability or capacity to ambulate) and to provide evidence-based guidelines for clinical practice.
The authors searched eight databases for papers including exercise interventions to improve gait and balance post-TBI. Twenty papers fully met inclusion criteria. The quality of studies was determined by the Physiotherapy Evidence Database (PEDro) scale and strength by Sackett's Levels of Evidence.
This study found limited evidence of the positive effects of balance, gait or the combination of both interventions in TBI rehabilitation. Most studies included small sample sizes with heterogeneous groups and the interventions were variable and lacked standardization. The outcome measures were variable and low in quality.
The state of evidence for gait and balance interventions in patients with mild-to-moderate TBI is surprisingly poor. Greater consideration and conformity in the choice of outcome measures and attention in the design and standardization treatment approaches are essential in future research to advance practice.
本综述旨在研究非有氧运动干预对功能轻度至中度创伤性脑损伤患者（即具有行走能力的患者）平衡和步态的疗效或有效性，并为临床实践提供循证指南。
作者检索了八个数据库，查找包含改善创伤性脑损伤后步态和平衡的运动干预的论文。20篇论文完全符合纳入标准。研究质量由物理治疗证据数据库（PEDro）量表确定，证据强度由萨克特证据等级确定。
本研究发现，在创伤性脑损伤康复中，平衡、步态或两种干预措施结合产生积极效果的证据有限。大多数研究样本量小，分组异质性大，干预措施多样且缺乏标准化。结局指标多样且质量低。
轻度至中度创伤性脑损伤患者步态和平衡干预的证据状况出奇地差。在未来研究中，为推进实践，在结局指标选择上应更加慎重并保持一致性，在设计和标准化治疗方法上应予以更多关注。
