1 Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
2 Loewenstein Rehabilitation Hospital, Raanana, Israel.
Neurorehabil Neural Repair. 2019 Mar;33(3):213-224. doi: 10.1177/1545968319829453. Epub 2019 Feb 15.
Reactive balance responses are critical for fall prevention. Perturbation-based balance training (PBBT) has shown a positive effect in reducing the risk of falls among older adults and persons with Parkinson's disease.
To explore the effect of a short-term PBBT on reactive balance responses, performance-based measures of balance and gait and balance confidence.
Thirty-four moderate-high functioning, subacute persons with stroke (PwS) (lower extremity Fugl-Meyer score 29.2 ± 4.3; Berg Balance Scale [BBS] score 43.8 ± 9.5, 42.0 ± 18.7 days after stroke onset) hospitalized in a rehabilitation setting were randomly allocated to PBBT (n = 18) and weight shifting and gait training (WS>) (n = 16). Both groups received 12 training sessions, 30 minutes each, for a period of 2.5 weeks. PBBT included unexpected balance perturbations during standing and treadmill walking, WS> included weight shifting in standing and treadmill walking without perturbations. The main outcome measures, that is, multiple step-threshold and fall-threshold were examined at baseline, immediately postintervention, and about 5 weeks postintervention. The secondary outcome measures, that is, BBS, 6-minute walk test (6MWT), 10-meter walk test (10MWT), and Activity-specific Balance Confidence (ABC) scale were examined at baseline and immediately postintervention.
Compared with the WS> group, immediately postintervention participants in the PBBT group showed higher multiple-step thresholds in response to forward and backward surface translations (effect size [ES] = 1.07 and ES = 1.10, respectively) and moderate ES in the ABC scale (ES = 0.74). No significant differences were found in fall-threshold, BBS, 6MWT, and 10MWT between the groups.
Inclusion of perturbation training during rehabilitation of PwS improved reactive balance and balance confidence.
反应性平衡反应对于预防跌倒至关重要。基于扰动的平衡训练（PBBT）已显示出可降低老年人和帕金森病患者跌倒风险的积极效果。
探讨短期 PBBT 对反应性平衡反应、基于表现的平衡和步态以及平衡信心的影响。
34 名功能中等偏上、亚急性期脑卒中患者（下肢 Fugl-Meyer 评分 29.2 ± 4.3；Berg 平衡量表 [BBS]评分 43.8 ± 9.5，发病后 42.0 ± 18.7 天）在康复环境中住院，随机分为 PBBT 组（n = 18）和重量转移和步态训练组（WS>）（n = 16）。两组均接受 12 次训练，每次 30 分钟，持续 2.5 周。PBBT 包括站立和跑步机行走时的意外平衡扰动，WS> 包括站立和跑步机行走时无扰动的重量转移。主要结局测量指标，即多步阈值和跌倒阈值，在基线、干预后即刻和干预后约 5 周进行评估。次要结局测量指标，即 BBS、6 分钟步行测试（6MWT）、10 米步行测试（10MWT）和活动特异性平衡信心量表（ABC 量表），在基线和干预后即刻进行评估。
与 WS> 组相比，PBBT 组的患者在面对前后表面平移时，即刻的多步阈值较高（效应量[ES]分别为 1.07 和 1.10），ABC 量表的中等 ES（ES = 0.74）。两组之间在跌倒阈值、BBS、6MWT 和 10MWT 方面均无显著差异。
在 PwS 的康复中加入扰动训练可改善反应性平衡和平衡信心。
