Department of Rehabilitation, Shu-Tien Urology and Ophthalmology Clinic, Taipei, Taiwan.
Am J Phys Med Rehabil. 2012 Jul;91(7):616-24. doi: 10.1097/PHM.0b013e3182555de3.
The aim of this study was to investigate the effects of a task-oriented ambulation training program in regaining walking, balance, and activity of daily living performance for ambulation-challenged residents with walking potential in long-term care facilities.
Fifty ambulation-challenged residents with walking potential were randomly assigned to an individualized task-oriented ambulation training group (30-45 mins, three times a week) or a routine nursing care control group for 4 wks. Each subject was evaluated by a blind evaluator before and after training. Walking function was assessed using walking speed, the Timed Up and Go Test, and the 6-Minute Walk Test. Balance and activities of daily living were measured using the Berg Balance Scale and the Barthel Index, respectively.
The training group showed significantly more improvement in walking speed, time to complete the Timed Up and Go Test, and the total score of Berg Balance Scale from baseline to posttest than the control group did. No significant difference between groups was observed on the 6-Minute Walk Test or the Barthel Index.
Ambulation-challenged residents with walking potential, as defined by slowing of walking speed with concomitant knee muscle weakness and joint range limitation, showed significant improvement in walking function and balance after a 4-wk task-oriented ambulation training in long-term care facilities.
本研究旨在探讨以任务为导向的步行训练方案对有步行能力的长期护理机构失能患者恢复步行、平衡和日常生活活动能力的影响。
50 名有步行能力但存在步行障碍的居民被随机分配到个体化任务导向步行训练组（30-45 分钟，每周 3 次）或常规护理对照组，进行 4 周的训练。每位受试者在训练前后均由盲法评估者进行评估。采用步行速度、计时起立行走测试和 6 分钟步行测试评估步行功能。采用 Berg 平衡量表和 Barthel 指数分别评估平衡和日常生活活动能力。
与对照组相比，训练组在步行速度、完成计时起立行走测试的时间以及 Berg 平衡量表总分方面的改善更为显著。6 分钟步行测试或 Barthel 指数在两组间无显著差异。
对于有步行能力但伴有步行速度减慢、膝关节肌无力和关节活动度受限的失能患者，在长期护理机构进行 4 周的以任务为导向的步行训练后，其步行功能和平衡能力显著改善。
