Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
Top Stroke Rehabil. 2020 May;27(4):262-271. doi: 10.1080/10749357.2019.1690795. Epub 2019 Nov 19.
: Reactive balance training (RBT) has been previously found to reduce fall risk in individuals with sub-acute stroke; however, our understanding of the effects of RBT on specific balance impairments is lacking.: To quantify changes in common balance reaction impairments in individuals with sub-acute stroke resulting from RBT, relative to traditional balance training, using a prospective cohort study design with a historical control group.: Individuals with sub-acute stroke completed either RBT or traditional balance training as part of their routine care during physiotherapy in inpatient rehabilitation. Reactive balance control was assessed using lean-and-release perturbations pre-intervention, post-intervention, and 6-months post-intervention (follow-up). Individuals with impaired balance reactions (delayed foot-off times, slide steps, and/or a preference for stepping with the preferred limb) at the pre-intervention assessment were identified using video and force plate data. Outcome measures (foot-off times, frequency of trials with slide steps, and stepping with the preferred limb) from the RBT participants with impaired reactions were compared for each of the three assessments to the mean values for the participants with impaired reactions in the historical control group.: Improvements were observed in all outcome measures for the RBT participants between pre-intervention and post-intervention, and/or between post-intervention and follow-up. These improvements were generally equivalent to, if not better than, the improvements demonstrated by the historical control group.: Findings further support the use of RBT for post-stroke inpatient rehabilitation, and provide insight into specific balance reaction impairments that are improved by RBT.
: 先前的研究表明,反应性平衡训练(RBT)可降低亚急性脑卒中患者的跌倒风险;然而,我们对 RBT 对特定平衡障碍影响的理解还很缺乏。: 本研究旨在通过前瞻性队列研究设计和历史对照组,定量评估亚急性脑卒中患者接受 RBT 相对于传统平衡训练后,常见平衡反应障碍的变化。: 亚急性脑卒中患者在住院康复期间的物理治疗中完成 RBT 或传统平衡训练。在干预前、干预后和干预后 6 个月(随访)使用倾斜和释放干扰来评估反应性平衡控制。使用视频和力板数据,根据干预前评估中个体的平衡反应受损情况(脚离地时间延迟、滑步和/或优先使用优势肢体),识别有受损反应的个体。对 RBT 参与者中具有受损反应的个体的反应时、滑步试验频率和使用优势肢体的试验比例的结果测量值,在三个评估中与历史对照组中具有受损反应的参与者的平均值进行比较。: RBT 参与者的所有结果测量值均在干预前和干预后之间以及/或在干预后和随访之间有所改善。这些改善通常与历史对照组的改善相当,甚至更好。: 研究结果进一步支持将 RBT 用于脑卒中后住院康复,并深入了解 RBT 可改善的特定平衡反应障碍。