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平衡锻炼计划减少了多发性硬化症患者的跌倒次数:一项单组前后测试验。

Balance exercise program reduced falls in people with multiple sclerosis: a single-group, pretest-posttest trial.

作者信息

Nilsagård Ylva Elisabet, von Koch Lena Kristina, Nilsson Malin, Forsberg Anette Susanne

机构信息

Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden; School of Medicine and Health, Örebro University, Örebro, Sweden.

Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden; Department of Neurology, Karolinska University Hospital, Solna, Sweden.

出版信息

Arch Phys Med Rehabil. 2014 Dec;95(12):2428-34. doi: 10.1016/j.apmr.2014.06.016. Epub 2014 Jul 6.

Abstract

OBJECTIVE

To evaluate the effects of a balance exercise program on falls in people with mild to moderate multiple sclerosis (MS).

DESIGN

Multicenter, single-blinded, single-group, pretest-posttest trial.

SETTING

Seven rehabilitation units within 5 county councils.

PARTICIPANTS

Community-dwelling adults with MS (N=32) able to walk 100m but unable to maintain 30-second tandem stance with arms alongside the body.

INTERVENTION

Seven weeks of twice-weekly, physiotherapist-led 60-minute sessions of group-based balance exercise targeting core stability, dual tasking, and sensory strategies (CoDuSe).

MAIN OUTCOME MEASURES

Primary outcomes: number of prospectively reported falls and proportion of participants classified as fallers during 7 preintervention weeks, intervention period, and 7 postintervention weeks. Secondary outcomes: balance performance on the Berg Balance Scale, Four Square Step Test, sit-to-stand test, timed Up and Go test (alone and with cognitive component), and Functional Gait Assessment Scale; perceived limitations in walking on the 12-item MS Walking Scale; and balance confidence on the Activities-specific Balance Confidence Scale rated 7 weeks before intervention, directly after intervention, and 7 weeks later.

RESULTS

Number of falls (166 to 43; P≤.001) and proportion of fallers (17/32 to 10/32; P≤.039) decreased significantly between the preintervention and postintervention periods. Balance performance improved significantly. No significant differences were detected for perceived limitations in walking, balance confidence, the timed Up and Go test, or sit-to-stand test.

CONCLUSIONS

The CoDuSe program reduced falls and proportion of fallers and improved balance performance in people with mild to moderate MS but did not significantly alter perceived limitations in walking and balance confidence.

摘要

目的

评估平衡训练计划对轻至中度多发性硬化症(MS)患者跌倒情况的影响。

设计

多中心、单盲、单组、干预前后测试试验。

地点

5个郡议会内的7个康复单元。

参与者

居住在社区的MS成年患者(N = 32),能够行走100米,但无法在双臂自然下垂身体两侧的情况下保持30秒的串联站立姿势。

干预措施

为期7周,由物理治疗师指导,每周两次,每次60分钟的基于小组的平衡训练课程,目标是核心稳定性、双重任务执行能力和感觉策略(CoDuSe)。

主要结局指标

主要结局:前瞻性报告的跌倒次数,以及在干预前7周、干预期和干预后7周被归类为跌倒者的参与者比例。次要结局:Berg平衡量表、四方步测试、坐立测试、计时起立行走测试(单独及包含认知成分)和功能性步态评估量表的平衡表现;12项MS步行量表中感知到的行走限制;以及干预前7周、干预后即刻和干预后7周在特定活动平衡信心量表上的平衡信心。

结果

干预前和干预期之间,跌倒次数(从166次降至43次;P≤0.001)和跌倒者比例(从17/32降至10/32;P≤0.039)显著降低。平衡表现显著改善。在行走感知限制、平衡信心、计时起立行走测试或坐立测试方面未检测到显著差异。

结论

CoDuSe计划减少了轻至中度MS患者的跌倒次数和跌倒者比例,并改善了平衡表现,但未显著改变行走感知限制和平衡信心。

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