Hollands Kristen L, Pelton Trudy A, Wimperis Andrew, Whitham Diane, Tan Wei, Jowett Sue, Sackley Catherine M, Wing Alan M, Tyson Sarah F, Mathias Jonathan, Hensman Marianne, van Vliet Paulette M
School of Health Sciences, University of Salford, Allerton Building, Salford, M6 6PU, United Kingdom.
Colleges of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
PLoS One. 2015 Oct 7;10(10):e0139261. doi: 10.1371/journal.pone.0139261. eCollection 2015.
Given the importance of vision in the control of walking and evidence indicating varied practice of walking improves mobility outcomes, this study sought to examine the feasibility and preliminary efficacy of varied walking practice in response to visual cues, for the rehabilitation of walking following stroke.
This 3 arm parallel, multi-centre, assessor blind, randomised control trial was conducted within outpatient neurorehabilitation services.
Community dwelling stroke survivors with walking speed <0.8m/s, lower limb paresis and no severe visual impairments.
Over-ground visual cue training (O-VCT), Treadmill based visual cue training (T-VCT), and Usual care (UC) delivered by physiotherapists twice weekly for 8 weeks.
Participants were randomised using computer generated random permutated balanced blocks of randomly varying size. Recruitment, retention, adherence, adverse events and mobility and balance were measured before randomisation, post-intervention and at four weeks follow-up.
Fifty-six participants participated (18 T-VCT, 19 O-VCT, 19 UC). Thirty-four completed treatment and follow-up assessments. Of the participants that completed, adherence was good with 16 treatments provided over (median of) 8.4, 7.5 and 9 weeks for T-VCT, O-VCT and UC respectively. No adverse events were reported. Post-treatment improvements in walking speed, symmetry, balance and functional mobility were seen in all treatment arms.
Outpatient based treadmill and over-ground walking adaptability practice using visual cues are feasible and may improve mobility and balance. Future studies should continue a carefully phased approach using identified methods to improve retention.
Clinicaltrials.gov NCT01600391.
鉴于视觉在步行控制中的重要性，且有证据表明多样化的步行练习可改善运动能力结果，本研究旨在探讨响应视觉提示进行多样化步行练习对中风后步行康复的可行性和初步疗效。
本三臂平行、多中心、评估者盲法随机对照试验在门诊神经康复服务机构内进行。
社区居住的中风幸存者，步行速度<0.8m/s，下肢轻瘫且无严重视力障碍。
由物理治疗师每周两次进行为期8周的地面视觉提示训练（O-VCT）、基于跑步机的视觉提示训练（T-VCT）和常规护理（UC）。
使用计算机生成的随机排列平衡块对参与者进行随机分组，随机块大小随机变化。在随机分组前、干预后和四周随访时测量招募、留存、依从性、不良事件以及运动能力和平衡情况。
56名参与者参与研究（18名接受T-VCT，19名接受O-VCT，19名接受UC）。34名完成了治疗和随访评估。在完成研究的参与者中，依从性良好，T-VCT、O-VCT和UC分别在（中位数）8.4周、7.5周和9周内提供了16次治疗。未报告不良事件。所有治疗组在治疗后步行速度、对称性、平衡和功能性移动能力均有改善。
基于门诊的使用视觉提示的跑步机和地面步行适应性练习是可行的，可能会改善运动能力和平衡。未来的研究应继续采用已确定的方法，谨慎地分阶段进行，以提高留存率。
Clinicaltrials.gov NCT01600391
