1 Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
2 Kunming Medical University, Kunming, China.
Clin Rehabil. 2018 Jul;32(7):865-877. doi: 10.1177/0269215518758482. Epub 2018 Feb 23.
OBJECTIVE: This systematic review aimed to examine the effects of dual-task balance and mobility training in people with stroke. METHODS: An extensive electronic databases literature search was conducted using MEDLINE, PubMed, EBSCO, The Cochrane Library, Web of Science, SCOPUS, and Wiley Online Library. Randomized controlled studies that assessed the effects of dual-task training in stroke patients were included for the review (last search in December 2017). The methodological quality was evaluated using the Cochrane Collaboration recommendation, and level of evidence was determined according to the criteria described by the Oxford Center for Evidence-Based Medicine. RESULTS: About 13 articles involving 457 participants were included in this systematic review. All had substantial risk of bias and thus provided level IIb evidence only. Dual-task mobility training was found to induce more improvement in single-task walking function (standardized effect size = 0.14-2.24), when compared with single-task mobility training. Its effect on dual-task walking function was not consistent. Cognitive-motor balance training was effective in improving single-task balance function (standardized effect size = 0.27-1.82), but its effect on dual-task balance ability was not studied. The beneficial effect of dual-task training on cognitive function was provided by one study only and thus inconclusive. CONCLUSION: There is some evidence that dual-task training can improve single-task walking and balance function in individuals with stroke. However, any firm recommendation cannot be made due to the weak methodology of the studies reviewed.
目的:本系统评价旨在探讨双重任务平衡和移动训练对中风患者的影响。
方法:通过 MEDLINE、PubMed、EBSCO、The Cochrane Library、Web of Science、SCOPUS 和 Wiley Online Library 进行了广泛的电子数据库文献检索。纳入了评估双重任务训练对中风患者影响的随机对照研究进行综述(最后一次检索时间为 2017 年 12 月)。使用 Cochrane 协作推荐评估方法学质量,并根据牛津循证医学中心描述的标准确定证据水平。
结果:本系统评价共纳入了 13 篇涉及 457 名参与者的文章。所有研究都存在较大的偏倚风险,因此仅提供 IIb 级证据。与单一任务移动训练相比,双重任务移动训练可使单任务行走功能(标准化效应量=0.14-2.24)得到更大改善。其对双重任务行走功能的影响并不一致。认知运动平衡训练在改善单任务平衡功能方面有效(标准化效应量=0.27-1.82),但尚未研究其对双重任务平衡能力的影响。一项研究仅提供了双重任务训练对认知功能有益的证据,因此结论不确定。
结论:有一些证据表明,双重任务训练可以改善中风患者的单任务行走和平衡功能。然而,由于所审查研究的方法学较弱,因此无法做出任何明确的建议。
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