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虚拟现实双重任务训练的初步研究:对慢性脑卒中幸存者行走和平衡的影响。

A Preliminary Study of Dual-Task Training Using Virtual Reality: Influence on Walking and Balance in Chronic Poststroke Survivors.

机构信息

The Academic College at Wingate, Wingate Institute, Netanya, Israel; The Israel Sport Center for the Disabled, Ramat Gan, Israel.

The Academic College at Wingate, Wingate Institute, Netanya, Israel; The Israel Sport Center for the Disabled, Ramat Gan, Israel.

出版信息

J Stroke Cerebrovasc Dis. 2019 Nov;28(11):104343. doi: 10.1016/j.jstrokecerebrovasdis.2019.104343. Epub 2019 Sep 5.

Abstract

BACKGROUND

Stroke is a leading cause of death and disability in the Western world, and leads to impaired balance and mobility.

OBJECTIVE

To investigate the feasibility of using a Virtual Reality-based dual task of an upper extremity while treadmill walking, to improve gait and functional balance performance of chronic poststroke survivors.

METHODS

Twenty-two individuals chronic poststroke participated in the study, and were divided into 2 groups (each group performing an 8-session exercise program): 11 participated in dual-task walking (DTW), and the other 11 participated in single-task treadmill walking (TMW). The study was a randomized controlled trial, with assessors blinded to the participants' allocated group. Measurements were conducted at pretest, post-test, and follow-up. Outcome measures included: the 10-m walking test (10 mW), Timed Up and Go (TUG), the Functional Reach Test (FRT), the Lateral Reach Test Left/Right (LRT-L/R); the Activities-specific Balance Confidence (ABC) scale, and the Berg Balance Scale(BBS).

RESULTS

Improvements were observed in balance variables: BBS, FRT, LRT-L/R, (P < .01) favoring the DTW group; in gait variables: 10 mW time, also favoring the DTW group (P < .05); and the ABC scale (P < .01). No changes for interaction were observed in the TUG.

CONCLUSIONS

The results of this study demonstrate the potential of VR-based DTW to improve walking and balance in people after stroke; thus, it is suggested to combine training sessions that require the performance of multiple tasks at the same time.

摘要

背景

中风是西方世界导致死亡和残疾的主要原因,会导致平衡和行动能力受损。

目的

研究在上肢进行虚拟现实(VR)双重任务的同时在跑步机上行走,是否能改善慢性中风幸存者的步态和功能性平衡表现。

方法

22 名慢性中风患者参与了这项研究,并被分为 2 组(每组进行 8 个疗程的锻炼计划):11 名参与者进行双重任务行走(DTW),另外 11 名参与者进行单任务跑步机行走(TMW)。该研究是一项随机对照试验,评估者对参与者的分组情况不知情。测量在预测试、后测试和随访时进行。结果测量包括:10 米步行测试(10 mW)、计时起身行走测试(TUG)、功能性伸展测试(FRT)、左右侧方伸展测试(LRT-L/R);活动特定平衡信心量表(ABC)和伯格平衡量表(BBS)。

结果

平衡变量得到改善:BBS、FRT、LRT-L/R(P <.01),DTW 组占优势;步态变量得到改善:10 mW 时间,也有利于 DTW 组(P <.05);ABC 量表(P <.01)。TUG 的交互作用没有变化。

结论

本研究结果表明,基于 VR 的 DTW 有可能改善中风后的行走和平衡能力;因此,建议将需要同时执行多项任务的训练课程结合起来。

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