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平衡信心与慢性卒中患者的平衡和步态特征相关。

Balance Confidence Is Related to Features of Balance and Gait in Individuals with Chronic Stroke.

作者信息

Schinkel-Ivy Alison, Wong Jennifer S, Mansfield Avril

机构信息

Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.

Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.

出版信息

J Stroke Cerebrovasc Dis. 2017 Feb;26(2):237-245. doi: 10.1016/j.jstrokecerebrovasdis.2016.07.022. Epub 2016 Dec 7.

DOI:10.1016/j.jstrokecerebrovasdis.2016.07.022
PMID:27955809
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5262475/
Abstract

BACKGROUND

Reduced balance confidence is associated with impairments in features of balance and gait in individuals with subacute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify the relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke.

METHODS

Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months postdischarge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable, and quiet standing, walking, and reactive stepping outcome measures as the dependent variables.

RESULTS

Walking velocity was positively correlated with balance confidence, whereas mediolateral center of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence.

CONCLUSIONS

This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs.

摘要

背景

平衡信心降低与亚急性中风患者的平衡和步态特征受损有关。然而,目前尚缺乏对中风恢复慢性期患者这些关系的了解。本研究旨在量化慢性中风患者平衡信心与平衡和步态特定特征之间的关系。

方法

参与者在住院中风康复出院后6个月完成平衡信心问卷和临床平衡评估(安静站立、行走和反应性跨步)。以平衡信心作为预测变量,安静站立、行走和反应性跨步结果测量作为因变量进行回归分析。

结果

步行速度与平衡信心呈正相关,而静立状态下的压力中心左右偏移以及双支撑时间、步幅宽度变异性和步幅时间变异性(行走时)与平衡信心呈负相关。

结论

本研究深入探讨了慢性中风患者平衡信心与平衡及步态测量之间的关系,表明平衡信心低的患者在安静站立控制以及与谨慎步态策略相关的行走特征方面存在受损。未来的工作应确定这些关系的方向,为慢性中风患者的社区中风康复计划提供参考,并确定将改善平衡信心的干预措施纳入这些计划的潜在效用。

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本文引用的文献

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The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation.住院卒中康复出院后跌倒对运动和认知恢复的影响
J Stroke Cerebrovasc Dis. 2016 Jul;25(7):1613-1621. doi: 10.1016/j.jstrokecerebrovasdis.2016.03.017. Epub 2016 Apr 6.
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Relationships between fear of falling, balance confidence, and control of balance, gait, and reactive stepping in individuals with sub-acute stroke.亚急性中风患者跌倒恐惧、平衡信心与平衡控制、步态及反应性跨步之间的关系。
Gait Posture. 2016 Jan;43:154-9. doi: 10.1016/j.gaitpost.2015.09.015. Epub 2015 Sep 28.
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Do measures of reactive balance control predict falls in people with stroke returning to the community?反应性平衡控制指标能否预测中风后重返社区的人群发生跌倒的情况?
Physiotherapy. 2015 Dec;101(4):373-80. doi: 10.1016/j.physio.2015.01.009. Epub 2015 Mar 25.
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The effect of interventions on balance self-efficacy in the stroke population: a systematic review and meta-analysis.干预措施对卒中患者平衡自我效能的影响:一项系统评价与荟萃分析。
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Clinical implementation of a reactive balance control assessment in a sub-acute stroke patient population using a 'lean-and-release' methodology.采用“倾斜-释放”方法对亚急性中风患者群体进行反应性平衡控制评估的临床应用。
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Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study.多发性硬化症患者跌倒的神经心理学、平衡和移动性风险因素:一项前瞻性队列研究。
Arch Phys Med Rehabil. 2014 Mar;95(3):480-6. doi: 10.1016/j.apmr.2013.09.017. Epub 2013 Oct 3.
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Gait Posture. 2014 Jan;39(1):177-81. doi: 10.1016/j.gaitpost.2013.06.022. Epub 2013 Jul 19.
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Is impaired control of reactive stepping related to falls during inpatient stroke rehabilitation?反应性跨步控制受损是否与住院脑卒中康复期间的跌倒有关?
Neurorehabil Neural Repair. 2013 Jul-Aug;27(6):526-33. doi: 10.1177/1545968313478486. Epub 2013 Mar 15.
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