Mustafaoğlu Rüstem, Erhan Belgin, Yeldan İpek, Ersöz Hüseyinsinoğlu Burcu, Gündüz Berrin, Razak Özdinçler Arzu
Department of Neurological Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Istanbul University, Faculty of Health Sciences, Istanbul, Turkey.
Department of Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Istanbul Aydın University, Faculty of Health Sciences, Istanbul, Turkey.
Turk J Phys Med Rehabil. 2018 Aug 15;64(4):344-352. doi: 10.5606/tftrd.2018.2672. eCollection 2018 Dec.
This study aims to compare effectiveness of isolated body weight-supported treadmill training (BWSTT) with conventional and combined training on balance, mobility, and fear of falling in stroke patients.
Between November 2014 and November 2015, a total of 45 post-stroke patients (32 males, 13 females; mean age 53.1±13.2 years; range, 19 to 73 years) were randomly assigned to combined training group (CombTG), conventional training group (CTG), and BWSTT group (BWSTTG). The CombTG received 45 min conventional therapy for five days a week along with 45 min of BWSTT twice a week. The CTG received only conventional therapy for five days a week. The BWSTTG received only BWSTT twice a week. Training duration was six weeks for all groups. Primary outcome measures were the Berg Balance Scale (BBS), affected and non-affected side Single Leg Stance Test (e-SLST/n-SLST), and Timed Up and Go Test (TUG) results. Secondary outcomes were the Falls Efficacy Scale-International (FES-I), Rivermead Mobility Index (RMI), Comfortable 10-m Walk Test (CWT), and Stair Climbing Test (SCT) results.
The mean change of outcome measures demonstrated that the improvements between groups were significantly different among the three groups, except for the CWT (p=0.135). In subgroup analysis, except for the RMI and CWT, all primary and secondary outcome measures improved significantly in favor of the CombTG, compared to the CTG and BWSTTG (p<0.016). However, no statistically significant difference was found in the mean change of the CTG and BWSTTG (p>0.05).
This study demonstrates that combined training has considerable effects on balance, mobility, and fear of falling parameters, while lower frequency of isolated BWSTT is as much effective as higher frequency of conventional training in ambulatory post-stroke patients.
本研究旨在比较单独的减重支持跑步机训练(BWSTT)与传统训练及联合训练对中风患者平衡能力、活动能力和跌倒恐惧的效果。
2014年11月至2015年11月期间,共45例中风后患者(男性32例,女性13例;平均年龄53.1±13.2岁;年龄范围19至73岁)被随机分配至联合训练组(CombTG)、传统训练组(CTG)和BWSTT组(BWSTTG)。联合训练组每周五天接受45分钟的传统治疗,同时每周两次接受45分钟的BWSTT训练。传统训练组每周仅接受五天的传统治疗。BWSTT组每周仅接受两次BWSTT训练。所有组的训练持续时间均为六周。主要结局指标为伯格平衡量表(BBS)、患侧和非患侧单腿站立测试(e-SLST/n-SLST)以及计时起立行走测试(TUG)结果。次要结局指标为国际跌倒效能量表(FES-I)、Rivermead活动指数(RMI)、舒适10米步行测试(CWT)以及爬楼梯测试(SCT)结果。
结局指标的平均变化表明,除CWT外(p = 0.135),三组之间的组间改善存在显著差异。在亚组分析中,与传统训练组和BWSTT组相比,除RMI和CWT外,联合训练组的所有主要和次要结局指标均有显著改善(p < 0.016)。然而,传统训练组和BWSTT组的平均变化未发现统计学上的显著差异(p > 0.05)。
本研究表明,联合训练对平衡能力、活动能力和跌倒恐惧参数有显著影响,而对于非卧床中风患者,较低频率的单独BWSTT与较高频率的传统训练效果相当。