Anson Eric, Ma Lei, Meetam Tippawan, Thompson Elizabeth, Rathore Roshita, Dean Victoria, Jeka John
Department of Otolaryngology Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States.
Department of Kinesiology, Temple University, Philadelphia, PA, United States; Department of Physical Therapy, Temple University, Philadelphia, PA, United States.
Gait Posture. 2018 May;62:342-348. doi: 10.1016/j.gaitpost.2018.03.044. Epub 2018 Mar 28.
Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes.
To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems.
40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk.
There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest.
Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function.
虚拟现实和增强反馈作为改善平衡的训练方法已变得更加普遍。关于在跑步机行走过程中提供躯干运动视觉反馈（VFB）的益处的报道很少，而且大多数此类报道仅描述了训练期间的变化。
确定躯干运动VFB跑步机行走是否能改善自我报告有平衡问题的老年人的地面平衡能力。
40名自我报告有平衡困难或跌倒史的成年人（75.8岁（标准差6.5））被随机分为对照组或实验组。每个人以舒适的速度在跑步机上行走，每周3次，共4周，每次2分钟，期间有坐姿休息。对照组被指示看向一个固定的靶心目标，而实验组除了看到固定靶心上叠加的一个移动光标外，还能看到代表其行走躯干运动的VFB。实验组被指示将光标保持在靶心中心。在干预前评估体感（单丝和关节位置测试）和前庭功能（特定半规管的临床头部脉冲测试）。在干预前后使用伯格平衡量表、BESTest、迷你BESTest和6分钟步行测试来测试平衡和活动能力。
干预前两组之间没有显著差异。实验组在BESTest（p = 0.031）和迷你BEST（p = 0.019）上有显著改善。对照组在任何测量指标上都没有显著改善。感觉障碍更严重的个体在BESTest的动态平衡子测试中有更大的改善。
自我报告有平衡问题的老年人在使用躯干运动VFB跑步机行走训练后，其动态平衡能力得到改善。感觉功能较差的个体在行走过程中可能比感觉功能正常的个体从躯干运动VFB中获益更多。
