Wang X-Q, Pi Y-L, Chen B-L, Chen P-J, Liu Y, Wang R, Li X, Waddington G
Sport Medicine and Rehabilitation Centre, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China.
Eur J Neurol. 2015 Mar;22(3):555-e37. doi: 10.1111/ene.12616. Epub 2015 Jan 5.
An increasing interest in the potential benefits of cognitive motor interference (CMI) for stroke has recently been observed, but the efficacy of CMI for gait and balance is controversial. A systematic review and meta-analysis of randomized controlled trials was performed to estimate the effect of CMI on gait and balance in patients with stroke.
Articles in Medline, EMBASE, the Cochrane Library, Web of Science, CINAHL, PEDro and the China Biology Medicine disc were searched from 1970 to July 2014. Only randomized controlled trials examining the effects of CMI for patients with stroke were included, and no language restrictions were applied. Main outcome measures included gait and balance function.
A total of 15 studies composed of 395 participants met the inclusion criteria, and 13 studies of 363 participants were used as data sources for the meta-analysis. Pooling revealed that CMI was superior to the control group for gait speed [mean difference (MD) 0.19 m/s, 95% confidence interval (CI) (0.06, 0.31), P = 0.003], stride length [MD 12.53 cm, 95% CI (4.07, 20.99), P = 0.004], cadence [MD 10.44 steps/min, 95% CI (4.17, 16.71), P = 0.001], centre of pressure sway area [MD -1.05, 95% CI (-1.85, -0.26), P = 0.01] and Berg balance scale [MD 2.87, 95% CI (0.54, 5.21), P = 0.02] in the short term.
Cognitive motor interference is effective for improving gait and balance function for stroke in the short term. However, only little evidence supports assumptions regarding CMI's long-term benefits.
最近人们越来越关注认知运动干扰（CMI）对中风的潜在益处，但CMI对步态和平衡的疗效仍存在争议。本研究进行了一项随机对照试验的系统评价和荟萃分析，以评估CMI对中风患者步态和平衡的影响。
检索了1970年至2014年7月期间Medline、EMBASE、Cochrane图书馆、科学网、CINAHL、PEDro和中国生物医学数据库中的文章。仅纳入了研究CMI对中风患者影响的随机对照试验，且无语言限制。主要结局指标包括步态和平衡功能。
共有15项研究（395名参与者）符合纳入标准，其中13项研究（363名参与者）作为荟萃分析的数据源。汇总分析显示，短期内CMI在步态速度[平均差（MD）0.19 m/s，95%置信区间（CI）（0.06，0.31），P = 0.003]、步长[MD 12.53 cm，95% CI（4.07，20.99），P = 0.004]、步频[MD 10.44步/分钟，95% CI（4.17，16.71），P = 0.001]、压力中心摆动面积[MD -1.05，95% CI（-1.85，-0.26），P = 0.01]和伯格平衡量表[MD 2.87，95% CI（0.54，5.21），P = 0.02]方面优于对照组。
认知运动干扰在短期内对改善中风患者的步态和平衡功能有效。然而，仅有很少的证据支持CMI长期益处的假设。
