使用 Biodex© 进行中风后上躯干姿势稳定性训练：一项初步研究。
Biodex© training post-stroke for postural stability in the upper trunk: A pilot study.
作者信息
Nel Helena W, Mudzi Witness, van Vuuren Elizabeth C Janse, Musenge Eustasius
机构信息
Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Physiotherapy, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
出版信息
S Afr J Physiother. 2020 Sep 30;76(1):1416. doi: 10.4102/sajp.v76i1.1416. eCollection 2020.
BACKGROUND
Stroke affects upper trunk postural stability and upper limb function in approximately 85% of stroke survivors. Upper trunk postural stability is essential for functioning of the upper limb and is a prerequisite for hand function. The rehabilitation of the upper limb and upper trunk post-stroke remains a challenge because of poor recovery of motor and sensory function.
OBJECTIVES
To determine the effect of Biodex© upper limb weight-bearing training on upper trunk postural stability in patients post-stroke.
METHOD
A longitudinal randomised control pilot trial with single blinding was undertaken to assess postural stability on the Biodex© at baseline and 1-month post-baseline. In addition to standard rehabilitative care, upper limb weight-bearing training on the Biodex© was added for participants in the experimental group. Descriptive data analysis and the Mann-Whitney test for group comparisons were done using STATA ( < 0.05).
RESULTS
Fifteen participants took part, seven in the control and eight in the experimental group, with an overall median age of 55 years. At baseline there were statistically significant lower scores in the experimental group on overall ( = 0.02) and anterior/posterior ( = 0.009) stability level 6 (moderately unstable base of support) in the upper trunk postural stability scores. No statistically significant improvements were noted between groups on any of the Biodex© stability levels at 1-month post-baseline testing ( > 0.05).
CONCLUSION
Upper limb weight-bearing training with the addition of Biodex© training did not result in improvements in upper trunk postural stability.
CLINICAL IMPLICATIONS
The findings suggest that exercising on a moderately unstable base of support may improve upper trunk postural stability in patients post-stroke. The addition of Biodex© training to standard rehabilitative care for retraining and exercising upper trunk postural control in a weight-bearing position does not lead to better outcomes than standard care.
背景
中风影响约85%的中风幸存者的上躯干姿势稳定性和上肢功能。上躯干姿势稳定性对于上肢功能至关重要，是手功能的先决条件。由于运动和感觉功能恢复不佳，中风后上肢和上躯干的康复仍然是一项挑战。
目的
确定Biodex©上肢负重训练对中风患者上躯干姿势稳定性的影响。
方法
进行了一项纵向随机对照试点试验，采用单盲法，在基线和基线后1个月评估Biodex©上的姿势稳定性。除标准康复护理外，实验组的参与者还增加了在Biodex©上的上肢负重训练。使用STATA进行描述性数据分析和组间比较的Mann-Whitney检验（<0.05）。
结果
15名参与者参加，对照组7名，实验组8名，总体中位年龄为55岁。在基线时，实验组在上躯干姿势稳定性评分的整体（=0.02）和前后（=0.009）稳定性水平6（支撑面中度不稳定）上的得分在统计学上显著较低。在基线后1个月测试时，两组在任何Biodex©稳定性水平上均未观察到统计学上的显著改善（>0.05）。
结论
添加Biodex©训练的上肢负重训练并未改善上躯干姿势稳定性。
临床意义
研究结果表明，在中度不稳定的支撑面上进行锻炼可能会改善中风患者的上躯干姿势稳定性。在标准康复护理中添加Biodex©训练以在负重位置重新训练和锻炼上躯干姿势控制，并不比标准护理产生更好的效果。
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