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动眼与注视稳定性训练对脑卒中后平衡功能的影响:临床试验方案

Effects of oculomotor and gaze stability exercises on balance after stroke: Clinical trial protocol.

作者信息

Pimenta Carla, Correia Anabela, Alves Marta, Virella Daniel

机构信息

Department of Physical Medicine and Rehabilitation, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Portugal.

Epidemiology and Statistics Office of the Research Unit, Centro Hospitalar de Lisboa Central, Portugal.

出版信息

Porto Biomed J. 2017 May-Jun;2(3):76-80. doi: 10.1016/j.pbj.2017.01.003. Epub 2017 Feb 12.

Abstract

HIGHLIGHTS

Balance problems after stroke are an important risk factor for falling.The inability to maintain balance decreased potential for recovery.This trial assesses the effect of oculomotor and gaze stability training on balance.

BACKGROUND

The inability to maintain balance after stroke is an important risk factor for falling and relates to decreased potential for recovery. The vestibular system and gaze stability contribute respectively to postural stability and to maintain balance. Rehabilitation may be more effective with domiciliary training.

OBJECTIVE

This trial aims to verify if balance impairment after stroke improves with a domiciliary oculomotor and gaze stability training program.

METHODS

Individuals older than 60 years, discharged after suffering brain stroke with referral to the physiotherapy department, will be assessed for orthostatic balance. Patients with stroke diagnosis 3-15 months before recruitment, positive Romberg test and able to walk 3 m alone are invited to participate in this randomized controlled trial. Participants will be allocated in two intervention groups through block randomization, either the current rehabilitation program or to a supplemental intervention focused on oculomotor and gaze stability exercises to be applied at home twice a day for three weeks. Primary outcome measures are the Motor Assessment Scale, Berg Balance Scale and Timed Up and Go Test. Trial registration: ClinicalTrials.gov (NCT02280980).

RESULTS

A minimum difference of four seconds in the TUG and a minimum difference of four points in BBS will be considered positive outcomes.

CONCLUSIONS

Oculomotor and gaze stability exercises may be a promising complement to conventional physiotherapy intervention after brain stroke, improving the balance impairment.

摘要

要点

中风后的平衡问题是跌倒的重要风险因素。无法维持平衡会降低恢复潜力。本试验评估眼动和注视稳定性训练对平衡的影响。

背景

中风后无法维持平衡是跌倒的重要风险因素,且与恢复潜力降低有关。前庭系统和注视稳定性分别有助于姿势稳定和维持平衡。居家训练的康复效果可能更佳。

目的

本试验旨在验证中风后的平衡障碍通过居家眼动和注视稳定性训练计划是否会得到改善。

方法

年龄大于60岁、因脑卒中介入物理治疗科后出院的个体,将接受直立平衡评估。招募前3至15个月诊断为中风、罗姆伯格试验阳性且能独自步行3米的患者受邀参加本随机对照试验。参与者将通过区组随机化分配到两个干预组,即现行康复计划组或侧重于眼动和注视稳定性练习的补充干预组,补充干预组需在家中每天进行两次,共持续三周。主要结局指标为运动评估量表、伯格平衡量表和定时起立行走测试。试验注册:ClinicalTrials.gov(NCT02280980)。

结果

定时起立行走测试中至少有4秒的差异以及伯格平衡量表中至少有4分的差异将被视为阳性结果。

结论

眼动和注视稳定性练习可能是中风后传统物理治疗干预的一种有前景的补充方法,可改善平衡障碍。

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