Lim Shannon B, Horslen Brian C, Davis Justin R, Allum John H J, Carpenter Mark G
Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
School of Kinesiology, University of British Columbia, Vancouver, Canada.
Gait Posture. 2016 Jun;47:10-7. doi: 10.1016/j.gaitpost.2016.03.017. Epub 2016 Mar 30.
Real-time balance-relevant biofeedback from a wearable sensor can improve balance in many patient populations, however, it is unknown if balance training with biofeedback has lasting benefits for healthy older adults once training is completed and biofeedback removed. This study was designed to determine if multi-session balance training with and without biofeedback leads to changes in balance performance in healthy older adults; and if changes persist after training. 36 participants (age 60-88) were randomly divided into two groups. Both groups trained on seven stance and gait tasks for 2 consecutive weeks (3×/week) while trunk angular sway and task duration were monitored. One group received real-time multi-modal biofeedback of trunk sway and a control group trained without biofeedback. Training effects were assessed at the last training session, with biofeedback available to the feedback group. Post-training effects (without biofeedback) were assessed immediately after, 1-week, and 1-month post-training. Both groups demonstrated training effects; participants swayed less when standing on foam with eyes closed (EC), maintained tandem-stance EC longer, and completed 8 tandem-steps EC faster and with less sway at the last training session. Changes in sway and duration, indicative of faster walking, were also observed after training for other gait tasks. While changes in walking speed persisted post-training, few other post-training effects were observed. These data suggest there is little added benefit to balance training with biofeedback, beyond training without, in healthy older adults. However, transient use of wearable balance biofeedback systems as balance aides remains beneficial for challenging balance situations and some clinical populations.
可穿戴传感器提供的与平衡相关的实时生物反馈能够改善许多患者群体的平衡能力，然而，对于健康的老年人而言，在完成训练并移除生物反馈后，基于生物反馈的平衡训练是否具有持久益处尚不清楚。本研究旨在确定在有生物反馈和无生物反馈的情况下进行多阶段平衡训练是否会导致健康老年人平衡能力的变化；以及训练后这些变化是否会持续存在。36名参与者（年龄在60 - 88岁之间）被随机分为两组。两组均连续两周（每周3次）针对七种站立和步态任务进行训练，同时监测躯干角摆动和任务持续时间。一组接受躯干摆动的实时多模态生物反馈，另一对照组在无生物反馈的情况下进行训练。在最后一次训练 session 时评估训练效果，反馈组可使用生物反馈。训练后效果（无生物反馈）在训练后立即、1周和1个月时进行评估。两组均表现出训练效果；在最后一次训练 session 时，参与者闭眼（EC）站在泡沫上时摆动减少，闭眼保持串联站立的时间更长，并且更快地完成8步串联行走，且摆动更小。在针对其他步态任务进行训练后，还观察到摆动和持续时间的变化，这表明步行速度加快。虽然训练后步行速度的变化持续存在，但几乎未观察到其他训练后效果。这些数据表明，对于健康的老年人来说，在平衡训练中使用生物反馈相较于不使用生物反馈几乎没有额外益处。然而，将可穿戴平衡生物反馈系统作为平衡辅助工具进行短暂使用，对于具有挑战性的平衡情况和一些临床人群仍然有益。
