Mihai Emanuela Elena, Mihai Ilie Valentin, Berteanu Mihai
Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy Bucharest, 050451 Bucharest, Romania.
Department of Telecommunications, University Politehnica of Bucharest, 060042 Bucharest, Romania.
J Clin Med. 2021 Dec 28;11(1):147. doi: 10.3390/jcm11010147.
Stroke remains one of the leading causes of disability in adults, and lower limb spasticity, affected stance, and balance impact everyday life and activities of such patients. Robotic therapy and assessment are becoming important tools to clinical evaluation for post-stroke rehabilitation. The aim of this study was to determine in a more objective manner the effects of visual feedback balance training through a balance trainer system and radial extracorporeal shock wave therapy (rESWT), along with conventional physiotherapy, on lower limb post-stroke spasticity, trunk control, and static and dynamic balance through clinical and stabilometric assessment. The study was designed as a randomized controlled trial. The experimental group underwent conventional physiotherapy, visual feedback balance training, and rESWT. The control group underwent conventional physiotherapy, visual feedback training and sham rESWT. The statistical analysis was performed using GraphPad Software and MATLAB. Primary clinical outcome measures were The Modified Ashworth Scale (MAS), passive range of motion (PROM), Visual Analogue Scale (VAS), and Clonus score. Secondary outcome measures were trunk performance, sensorimotor, and lower limb function. Stabilometric outcome measures were trunk control, static balance, and dynamic balance. Visual feedback training using the Prokin system and rESWT intervention, along with conventional physiotherapy, yielded statistically significant improvement both on clinical and stabilometric outcome measures, enhancing static and dynamic balance, trunk performance, sensorimotor outcome, and limb function and considerably diminishing lower limb spasticity, pain intensity, and clonus score in the experimental group.
中风仍然是成年人残疾的主要原因之一，下肢痉挛、异常姿势和平衡问题会影响此类患者的日常生活和活动。机器人治疗和评估正成为中风后康复临床评估的重要工具。本研究的目的是通过临床和稳定测量评估，以更客观的方式确定通过平衡训练系统进行的视觉反馈平衡训练和径向体外冲击波疗法（rESWT）以及传统物理治疗对中风后下肢痉挛、躯干控制以及静态和动态平衡的影响。该研究设计为随机对照试验。实验组接受传统物理治疗、视觉反馈平衡训练和rESWT。对照组接受传统物理治疗、视觉反馈训练和假rESWT。使用GraphPad软件和MATLAB进行统计分析。主要临床结局指标为改良Ashworth量表（MAS）、被动活动范围（PROM）、视觉模拟量表（VAS）和阵挛评分。次要结局指标为躯干表现、感觉运动和下肢功能。稳定测量结局指标为躯干控制、静态平衡和动态平衡。在实验组中，使用Prokin系统进行视觉反馈训练和rESWT干预以及传统物理治疗，在临床和稳定测量结局指标上均产生了统计学上的显著改善，增强了静态和动态平衡、躯干表现、感觉运动结局和肢体功能，并显著降低了下肢痉挛、疼痛强度和阵挛评分。
