基于 Kinect 的快速运动训练改善脑卒中后跌倒平衡恢复：一项随机对照试验。
Kinect-based rapid movement training to improve balance recovery for stroke fall prevention: a randomized controlled trial.
机构信息
Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China.
Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, SAR, China.
出版信息
J Neuroeng Rehabil. 2021 Oct 11;18(1):150. doi: 10.1186/s12984-021-00922-3.
BACKGROUND
Falls are more prevalent in stroke survivors than age-matched healthy older adults because of their functional impairment. Rapid balance recovery reaction with adequate range-of-motion and fast response and movement time are crucial to minimize fall risk and prevent serious injurious falls when postural disturbances occur. A Kinect-based Rapid Movement Training (RMT) program was developed to provide real-time feedback to promote faster and larger arm reaching and leg stepping distances toward targets in 22 different directions.
OBJECTIVE
To evaluate the effectiveness of the interactive RMT and Conventional Balance Training (CBT) on chronic stroke survivors' overall balance and balance recovery reaction.
METHODS
In this assessor-blinded randomized controlled trial, chronic stroke survivors were randomized to receive twenty training sessions (60-min each) of either RMT or CBT. Pre- and post-training assessments included clinical tests, as well as kinematic measurements and electromyography during simulated forward fall through a "lean-and-release" perturbation system.
RESULTS
Thirty participants were recruited (RMT = 16, CBT = 14). RMT led to significant improvement in balance control (Berg Balance Scale: pre = 49.13, post = 52.75; P = .001), gait control (Timed-Up-and-Go Test: pre = 14.66 s, post = 12.62 s; P = .011), and motor functions (Fugl-Meyer Assessment of Motor Recovery: pre = 60.63, post = 65.19; P = .015), which matched the effectiveness of CBT. Both groups preferred to use their non-paretic leg to take the initial step to restore stability, and their stepping leg's rectus femoris reacted significantly faster post-training (P = .036).
CONCLUSION
The RMT was as effective as conventional balance training to provide beneficial effects on chronic stroke survivors' overall balance, motor function and improving balance recovery with faster muscle response.
TRIAL REGISTRATION
The study was registered at Clinicaltrials.gov ( https://clinicaltrials.gov/ct2/show/NCT03183635 , NCT03183635) on 12 June 2017.
背景
由于功能受损，中风幸存者比年龄匹配的健康老年人更容易摔倒。快速的平衡恢复反应，具有足够的运动范围和快速的反应和运动时间，对于最大限度地降低跌倒风险和防止姿势障碍发生时发生严重伤害性跌倒至关重要。一种基于 Kinect 的快速运动训练（RMT）程序被开发出来，为促进更快和更大的手臂向 22 个不同方向的目标伸展以及腿部踏进步距提供实时反馈。
目的
评估交互式 RMT 和常规平衡训练（CBT）对慢性中风幸存者整体平衡和平衡恢复反应的有效性。
方法
在这项评估员盲法随机对照试验中，慢性中风幸存者被随机分配接受 20 次训练（每次 60 分钟），分别接受 RMT 或 CBT。训练前后评估包括临床测试，以及通过“倾斜和释放”扰动系统进行模拟前向跌倒时的运动学测量和肌电图。
结果
共招募了 30 名参与者（RMT = 16，CBT = 14）。RMT 显著改善了平衡控制（伯格平衡量表：前 = 49.13，后 = 52.75；P =.001）、步态控制（计时起立行走测试：前 = 14.66 s，后 = 12.62 s；P =.011）和运动功能（Fugl-Meyer 运动功能评估：前 = 60.63，后 = 65.19；P =.015），与 CBT 的效果相当。两组均倾向于使用非瘫痪侧腿迈出初始步以恢复稳定性，并且训练后其踏步腿的股直肌反应明显更快（P =.036）。
结论
RMT 与常规平衡训练一样有效，可对慢性中风幸存者的整体平衡、运动功能产生有益影响，并通过更快的肌肉反应改善平衡恢复。
试验注册
该研究于 2017 年 6 月 12 日在 Clinicaltrials.gov（https://clinicaltrials.gov/ct2/show/NCT03183635，NCT03183635）注册。
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