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体重转移训练对慢性脑卒中患者平衡控制和体重分布的影响:一项初步研究。

Effects of weight-shift training on balance control and weight distribution in chronic stroke: a pilot study.

机构信息

Department of Physiotherapy, Alexander Technological Educational Institute, Thessaloniki, Greece.

出版信息

Top Stroke Rehabil. 2012 Jan-Feb;19(1):23-31. doi: 10.1310/tsr1901-23.

Abstract

PURPOSE

The objective was to evaluate the effect of weight-shift training on functional balance, weight distribution, and postural control measures during standing and forward reach tasks in subjects with chronic stroke.

METHODS

Nine male subjects (mean age, 66 years; range, 60-75 years) who experienced a stroke 3 to 13 years previously participated in a 4-week training program consisting of static and dynamic balance exercises with visual feedback and gait training with wall support. Balance control was assessed before and after the intervention with clinical measures (Berg Balance Scale) and with a pressure platform for registering the center of pressure (CoP) during quiet stance (weight distribution, CoP sway area, and velocity), and during a forward reach task at shoulder and knee levels. Intervention effects were evaluated with the Wilcoxon matched-pairs test.

RESULTS

After training, the group improved their Berg Balance Scale median score from 42 (range, 14-54) to 46 (20-55) (P = .01), CoP sway area [10.6 (5.0-31.4) to 3.0 (1.8-10.8) cm2; P = .01], and mean velocity [3.5 (2.4-8.0) to 1.7 (0.9-3.7) mm/s; P = .01] during quiet standing but not weight distribution (P = .59). During the forward reach tasks, most of the postural control measures such as movement time, CoP displacement, and CoP velocity were significantly (P < .05) improved after the training period for both the affected and nonaffected sides as compared to before the training period.

CONCLUSION

A weight-shift training program improved balance control but not weight distribution in a group of chronic stroke subjects. Larger, randomized, and controlled studies are necessary.

摘要

目的

评估在慢性脑卒中患者中,通过重量转移训练对站立和向前伸展任务中的功能性平衡、体重分布和姿势控制措施的影响。

方法

9 名男性患者(平均年龄 66 岁;范围,60-75 岁),在脑卒中后 3-13 年参与了一个为期 4 周的训练计划,包括静态和动态平衡练习以及视觉反馈、墙壁支撑下的步态训练。干预前后使用临床测量(伯格平衡量表)和压力平台评估平衡控制,以测量在安静站立时(体重分布、压力中心晃动面积和速度)和肩部和膝盖水平的向前伸展任务时的压力中心(CoP)。使用 Wilcoxon 配对检验评估干预效果。

结果

训练后,该组的伯格平衡量表中位数评分从 42(范围,14-54)提高到 46(20-55)(P =.01),CoP 晃动面积从 10.6(5.0-31.4)减少到 3.0(1.8-10.8)cm2(P =.01),平均速度从 3.5(2.4-8.0)减少到 1.7(0.9-3.7)mm/s(P =.01),但体重分布没有改变(P =.59)。在向前伸展任务中,与训练前相比,大多数姿势控制措施(如运动时间、CoP 位移和 CoP 速度)在训练后都有显著改善(P <.05),无论是患侧还是非患侧。

结论

重量转移训练方案可改善慢性脑卒中患者的平衡控制,但不能改善体重分布。需要更大、随机和对照的研究。

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