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膈肌呼吸联合腹部内收训练对脑卒中后步行功能的随机对照研究方案。

Diaphragmatic breathing combined with abdominal drawing-in maneuver for walking function in post-stroke patients: a randomized controlled study protocol.

机构信息

Department of Neurological Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China.

Department of Osteoarticular Rehabilitation, the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Trials. 2023 Oct 19;24(1):677. doi: 10.1186/s13063-023-07690-6.

Abstract

BACKGROUND

Patients with stroke frequently experience walking dysfunction. Core training can help improve balance and walking function in patients with stroke. However, core training movements in clinical practice are numerous and differently targeted. Therefore, this study will investigate the improvement of walking function in patients with combined diaphragmatic breathing maneuver (DBM) and draw-in breathing technique (ADIM) training.

METHODS

This single-blind, randomized controlled preliminary will analyze the viability of DBM combined ADIM training versus routine rehabilitation therapy in patients with stroke with early to mid-stroke. Patients will be randomly assigned to either the DBM and ADIM training or the routine rehabilitation training. We will recruit 42 stroke inpatients from the Second Rehabilitation Hospital of Shanghai who meet the trial criteria and measure the balance and walking functions and improvement of that after 4 weeks of intervention. The primary outcome is the 10 m maximum walking test (10MWT). The secondary outcomes indices include the limits of stability test (LOS), Berg balance scale test (BBS), Functional Ambulation Categories test (FAC), Timed Up and Go test (TUG), trunk impairment scale test (TIS), ultrasound indicators of the diaphragm and transversus abdominis (UI), rhythmic weight shift test (RWS), walk across test (WA), Fugl-Meyer assessment of lower extremity (FMA-LE), and Barthel index of ADL test.

DISCUSSION

The primary objective of this project was to investigate the effects of DBM combined with ADIM on balance capacity and walking function for patients with early to mid-stroke. The outcomes of this study will hold significant implications for future clinical applications in rehabilitation.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2100054897. Registered on 28 December 2021.

摘要

背景

脑卒中患者常出现步行功能障碍。核心训练有助于改善脑卒中患者的平衡和步行功能。然而,临床实践中的核心训练动作众多,且针对性不同。因此,本研究将探讨联合膈式呼吸训练(DBM)和缩腹呼吸技术(ADIM)对脑卒中患者步行功能的改善作用。

方法

这是一项单盲、随机对照的初步研究,将分析早期至中期脑卒中患者进行 DBM 联合 ADIM 训练与常规康复治疗的可行性。患者将被随机分配到 DBM 和 ADIM 训练组或常规康复训练组。我们将从上海第二康复医院招募 42 名符合试验标准的脑卒中住院患者,测量他们在干预 4 周后的平衡和步行功能以及改善情况。主要结局指标是 10m 最大步行测试(10MWT)。次要结局指标包括:平衡极限测试(LOS)、伯格平衡量表测试(BBS)、功能性步行分类测试(FAC)、计时起立行走测试(TUG)、躯干损伤量表测试(TIS)、膈肌和腹横肌超声指标(UI)、节律性体重转移测试(RWS)、步行穿越测试(WA)、下肢 Fugl-Meyer 评估(FMA-LE)和日常生活活动能力 Barthel 指数测试(ADL)。

讨论

本项目的主要目的是研究 DBM 联合 ADIM 对早期至中期脑卒中患者平衡能力和步行功能的影响。该研究的结果将对未来康复临床应用具有重要意义。

试验注册

中国临床试验注册中心(ChiCTR),ID:ChiCTR2100054897。注册于 2021 年 12 月 28 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/727b/10588227/4c1b6eaaedde/13063_2023_7690_Fig1_HTML.jpg

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