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亚急性卒中患者的前庭康复训练:一项初步随机对照试验。

Vestibular rehabilitation training in patients with subacute stroke: A preliminary randomized controlled trial.

作者信息

Tramontano Marco, Bergamini Elena, Iosa Marco, Belluscio Valeria, Vannozzi Giuseppe, Morone Giovanni

机构信息

Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia (Scientific Institute for Research and Health Care), Rome, Italy.

Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.

出版信息

NeuroRehabilitation. 2018;43(2):247-254. doi: 10.3233/NRE-182427.

Abstract

BACKGROUND

Vestibular rehabilitation (VR) consists in a customized exercise program patient-centred that includes a combination of different exercise components with the aim to promote gaze stability, improve balance and gait, and facilitate somatosensory integration.

OBJECTIVE

The aim of this study was to investigate the effect of customized vestibular rehabilitation training on gait stability of patients with subacute stroke.

METHODS

Twenty-five inpatients (12 M, age: 64.1±12.1 years) with diagnosis of subacute stroke were enrolled and randomized in two groups. All patients were evaluated before and after 4 weeks of training sessions. An instrumented 10-Meter Walk Test together with traditional clinical scales were used to assess VR effects. To investigate if any fall event occurred after patients' dismissal, they were followed-up at three and twelve months after dismissal.

RESULTS

Higher values of walking speed and stride length were observed in the VR group. Conversely, no significant difference was found in terms of trunk stability. The results of between-group comparison highlight significant differences between the two groups for different clinical scale scores.

CONCLUSION

VR could be included into a rehabilitation program for patients with stroke for improving their gait and dynamic balance acting on their vestibular system as facilitator of recovery.

摘要

背景

前庭康复(VR)是一项以患者为中心的定制化锻炼计划,包括多种锻炼成分的组合,旨在促进注视稳定、改善平衡和步态,并促进体感整合。

目的

本研究旨在探讨定制化前庭康复训练对亚急性脑卒中患者步态稳定性的影响。

方法

纳入25例诊断为亚急性脑卒中的住院患者(12例男性,年龄:64.1±12.1岁),随机分为两组。所有患者在训练4周前后均进行评估。采用仪器化10米步行试验及传统临床量表评估VR效果。为调查患者出院后是否发生任何跌倒事件,在出院后3个月和12个月对他们进行随访。

结果

VR组观察到步行速度和步幅长度值更高。相反,在躯干稳定性方面未发现显著差异。组间比较结果突出了两组在不同临床量表评分上的显著差异。

结论

VR可纳入脑卒中患者的康复计划,通过作用于其前庭系统作为恢复促进因素来改善他们的步态和动态平衡。

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