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一项关于附加核心稳定性练习训练改善脑卒中患者动态坐位平衡和躯干控制的随机对照试验的长期随访。

Long-term follow-up of a randomized controlled trial on additional core stability exercises training for improving dynamic sitting balance and trunk control in stroke patients.

机构信息

1 Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Catalonia, Spain.

2 Department of Physiotherapy (Biostatistics Unit), Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Catalonia, Spain.

出版信息

Clin Rehabil. 2017 Nov;31(11):1492-1499. doi: 10.1177/0269215517701804. Epub 2017 Mar 29.

Abstract

OBJECTIVE

Analyse the effect of core stability exercises in addition to conventional physiotherapy training three months after the intervention ended.

DESIGN

A randomized controlled trial.

SETTING

Outpatient services.

SUBJECTS

Seventy-nine stroke survivors.

INTERVENTIONS

In the intervention period, both groups underwent conventional physiotherapy performed five days/week for five weeks, and in addition the experimental group performed core stability exercises for 15 minutes/day. Afterwards, during a three-month follow-up period, both groups underwent usual care that could eventually include conventional physiotherapy or physical exercise but not in a controlled condition.

MAIN MEASURES

Primary outcome was trunk control and dynamic sitting balance assessed by the Spanish-Version of Trunk Impairment Scale 2.0 and Function in Sitting Test. Secondary outcomes were standing balance and gait evaluated by the Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Spanish-Version of Postural Assessment Scale for Stroke and activities of daily living using the Barthel Index.

RESULTS

A total of 68 subjects out of 79 completed the three-month follow-up period. The mean difference (SD) between groups was 0.78 (1.51) points ( p = 0.003) for total score on the Spanish-Version of Trunk Impairment Scale 2.0, 2.52 (6.46) points ( p = 0.009) for Function in Sitting Test, dynamic standing balance was 3.30 (9.21) points ( p= 0.009) on the Berg Balance Scale, gait was 0.82 (1.88) points ( p = 0.002) by Brunel Balance Assessment (stepping), and 1.11 (2.94) points ( p = 0.044) by Tinetti Test (gait), all in favour of core stability exercises.

CONCLUSIONS

Core stability exercises plus conventional physiotherapy have a positive long-term effect on improving dynamic sitting and standing balance and gait in post-stroke patients.

摘要

目的

分析干预结束三个月后,核心稳定性练习对常规物理治疗的附加影响。

设计

随机对照试验。

设置

门诊服务。

受试者

79 名脑卒中幸存者。

干预

在干预期间,两组均接受每周 5 天、共 5 周的常规物理治疗,此外实验组还每天进行 15 分钟的核心稳定性练习。之后,在为期三个月的随访期间,两组均接受常规护理,最终可能包括常规物理治疗或体育锻炼,但不受控制。

主要观察指标

主要结局指标为躯干控制和动态坐姿平衡,采用西班牙语版躯干损伤量表 2.0 和坐姿功能测试进行评估。次要结局指标为站立平衡和步态,采用伯格平衡量表、Tinetti 测试、布鲁内尔平衡评估、西班牙语版脑卒中姿势评估量表和日常生活活动采用 Barthel 指数进行评估。

结果

79 名受试者中共有 68 名完成了三个月的随访期。西班牙语版躯干损伤量表 2.0 总评分组间平均差异(标准差)为 0.78(1.51)分( p = 0.003),坐姿功能测试为 2.52(6.46)分( p = 0.009),伯格平衡量表的动态站立平衡为 3.30(9.21)分( p = 0.009), Brunel 平衡评估(跨步)的步态为 0.82(1.88)分( p = 0.002),Tinetti 测试(步态)的步态为 1.11(2.94)分( p = 0.044),所有结果均有利于核心稳定性练习。

结论

核心稳定性练习加常规物理治疗对改善脑卒中后患者的动态坐姿和站立平衡以及步态具有积极的长期影响。

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