Kramer Andreas, Dettmers Christian, Gruber Markus
Sensorimotor Performance Lab, Department of Sports Sciences, University of Konstanz, Konstanz, Germany.
Clinics Schmieder, Konstanz, Germany.
Arch Phys Med Rehabil. 2014 Oct;95(10):1803-9. doi: 10.1016/j.apmr.2014.04.020. Epub 2014 May 10.
To assess the effectiveness of and adherence to an exergame balance training program with additional postural demands in patients with multiple sclerosis (MS).
Matched controlled trial, assessment of balance before and after different balance training programs, and adherence to home-based balance exercise in the 6 months after the training.
A neurorehabilitation facility and center for MS.
Patients with balance problems (N=70) matched into 1 of the training groups according to age as well as balance and gait performance in 4 tests. Nine patients dropped out of the study because of scheduling problems. The mean age of the 61 remaining participants was 47±9 years, and their Expanded Disability Status Scale score was 3±1.
Three weeks of (1) conventional balance training (control), (2) exergame training (playing exergames on an unstable platform), or (3) single-task (ST) exercises on the unstable platform.
Test scores in balance tests and gait analyses under ST and dual-task (DT) situations. Furthermore, in the 6 months after the rehabilitation training, the frequency and type of balance training were assessed by using questionnaires.
All 3 groups showed significantly improved balance and gait scores. Only the exergame training group showed significantly higher improvements in the DT condition of the gait test than in the ST condition. Adherence to home-based balance training differed significantly between groups (highest adherence in the exergame training group).
Playing exergames on an unstable surface seems to be an effective way to improve balance and gait in patients with MS, especially in DT situations. The integration of exergames seems to have a positive effect on adherence and is thus potentially beneficial for the long-term effectiveness of rehabilitation programs.
评估一款具有额外姿势要求的运动游戏平衡训练方案对多发性硬化症（MS）患者的有效性及依从性。
配对对照试验，评估不同平衡训练方案前后的平衡能力，并在训练后的6个月内评估家庭平衡训练的依从性。
一家神经康复机构及MS中心。
有平衡问题的患者（N = 70），根据年龄以及4项测试中的平衡和步态表现匹配到1个训练组中。9名患者因日程安排问题退出研究。其余61名参与者的平均年龄为47±9岁，其扩展残疾状态量表评分为3±1。
为期3周的（1）传统平衡训练（对照组）、（2）运动游戏训练（在不稳定平台上玩运动游戏）或（3）在不稳定平台上进行单任务（ST）练习。
ST和双任务（DT）情况下平衡测试和步态分析的测试分数。此外，在康复训练后的6个月内，通过问卷调查评估平衡训练的频率和类型。
所有3组的平衡和步态分数均有显著改善。只有运动游戏训练组在步态测试的DT条件下的改善明显高于ST条件。各组之间家庭平衡训练的依从性存在显著差异（运动游戏训练组的依从性最高）。
在不稳定表面上玩运动游戏似乎是改善MS患者平衡和步态的有效方法，尤其是在DT情况下。运动游戏的融入似乎对依从性有积极影响，因此可能有利于康复方案的长期效果。
