传统中式运动对中风患者步态和平衡的影响：一项系统评价与荟萃分析
Effect of Traditional Chinese Exercise on Gait and Balance for Stroke: A Systematic Review and Meta-Analysis.
作者信息
Chen Bing-Lin, Guo Jia-Bao, Liu Ming-Shuo, Li Xin, Zou Jun, Chen Xi, Zhang Ling-Li, Yue Yu-Shan, Wang Xue-Qiang
机构信息
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Second School of Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, China.
出版信息
PLoS One. 2015 Aug 20;10(8):e0135932. doi: 10.1371/journal.pone.0135932. eCollection 2015.
OBJECTIVE
A systematic review is conducted to determine the effect of traditional Chinese exercise for patients with stroke.
METHODS
Studies are obtained from PubMed, Embase, Cochrane Library, EBSCO, Web of Science, and CNKI. Only randomized controlled trials were left to evaluate the effects of traditional Chinese exercise for patients with stroke, and with no limits on study data or language. The primary outcome was the Berg balance score (BBS), Functional walking scale. And a random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI).
RESULTS
A total of 9 studies on 820 participants conform to the inclusion criteria, whereas eight studies on 704 participants are used as data sources for the meta-analysis, all trials were published between 2004 and 2013. The BBS indicates that the efficacy of traditional Chinese exercise on balance of patients with stroke is better than that of other training or no training in short term [MD (95%CI) = 11.85 [5.41, 18.30], P < 0.00001]. And the short physical performance battery, Functional walking scale, limit of stability were observed significant differences on balance (p<0.05) and gait (p<0.05) between traditional Chinese exercise and other exercises or no exercise. In addition, there is an article showed that some other form (physiotherapy exercises focused on balance) significantly improved balance ability for stroke patients compared to tai chi chuan practice (Berg test = 0.01, Romberg, and standing on one leg).
CONCLUSION
In our meta analysis, the positive findings of this study suggest traditional Chinese exercise has beneficial effects on the balance ability in short term. However, we drew the conclusion according to the extreme heterogeneity, and evidence of better quality and from a larger sample size is required. Because of the inconsistent outcomes, there are short of enough good evidence for patients with stroke to prove the effects of traditional Chinese exercise on gait.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO PROSPERO registration number: CRD42013006474.
目的
进行一项系统评价，以确定传统中医疗法对中风患者的影响。
方法
从PubMed、Embase、Cochrane图书馆、EBSCO、科学引文索引和中国知网获取研究。仅保留随机对照试验来评估传统中医疗法对中风患者的疗效，对研究数据和语言无限制。主要结局指标为伯格平衡量表（BBS）、功能性步行量表。采用随机效应模型计算合并均数差（MD）及95%置信区间（CI）。
结果
共有9项涉及820名参与者的研究符合纳入标准，其中8项涉及704名参与者的研究用作荟萃分析的数据来源，所有试验均发表于2004年至2013年之间。BBS表明，传统中医疗法在短期内对中风患者平衡能力的疗效优于其他训练或无训练[MD（95%CI）=11.85[5.41，18.30]，P<0.00001]。此外，短身体功能量表、功能性步行量表、稳定极限在传统中医疗法与其他运动或无运动之间的平衡（p<0.05）和步态（p<0.05）方面观察到显著差异。另外，有一篇文章表明，与太极拳练习相比，其他某种形式（专注于平衡的物理治疗运动）能显著改善中风患者的平衡能力（伯格测试=0.01，罗姆伯格测试和单腿站立测试）。
结论
在我们的荟萃分析中，本研究的阳性结果表明传统中医疗法在短期内对平衡能力有有益影响。然而，我们是根据极端异质性得出的结论，需要质量更高、样本量更大的证据。由于结果不一致，缺乏足够的有力证据来证明传统中医疗法对中风患者步态的影响。
系统评价注册
http://www.crd.york.ac.uk/PROSPERO PROSPERO注册号：CRD42013006474。
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