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节律性听觉刺激对脑卒中后功能性步行的影响:系统评价。

The effects of rhythmic auditory stimulation on functional ambulation after stroke: a systematic review.

机构信息

Neurorehabilitation department, Hospital Sociosanitari Mutuam Girona, 17007, Girona, Catalonia, Spain.

Department of Nursing, Faculty of Nursing, University of Girona, 17003, Girona, Spain.

出版信息

BMC Complement Med Ther. 2024 Jan 20;24(1):45. doi: 10.1186/s12906-023-04310-3.

Abstract

BACKGROUND

Several studies have reported the effect of rhythmic auditory stimulation (RAS) on functional ambulation in stroke patients, yet no systematic overview has yet been published. This study aims to synthesize the available evidence describing changes in stroke patients after RAS intervention for functional ambulation and the use of walking assistive devices, and to find out if the effect of RAS and music-based RAS differs depending on the lesioned area.

METHODS

The PubMed, PEDro, Cochrane Central Register of Controlled Trials, Web of Science, Scopus and CINAHL electronic databases were searched for reports evaluating the effect of RAS on walking in stroke patients, applying the PICOS criteria for the inclusion of studies.

RESULTS

Twenty one articles were included (948 stroke survivors). Most studies were of good methodological quality according to the PEDro scale, but they had a high risk of bias. The most consistent finding was that RAS improves walking and balance parameters in stroke patients in all phases compared to baseline and versus control groups with conventional treatment. Functional ambulation and the use of walking assistive devices were inconsistently reported. Several studies also suggest that RAS may be as good as other complementary therapies (horse-riding and visual cueing).

CONCLUSIONS

Despite the beneficial effects of RAS, the question remains as to whether it is better than other complementary therapies. Given the heterogeneity of the interventions, the interventions in control groups, the varied durations, and the different outcome measures, we suggest that care should be taken in interpreting and generalizing findings.

PROSPERO REGISTRATION

CRD42021277940.

摘要

背景

多项研究报告了节律性听觉刺激(RAS)对脑卒中患者功能性步行的影响,但尚未发表系统综述。本研究旨在综合现有证据,描述 RAS 干预对脑卒中患者功能性步行和步行辅助器具使用的影响,并探讨 RAS 和基于音乐的 RAS 是否因损伤部位不同而产生不同的效果。

方法

通过 PubMed、PEDro、Cochrane 中心对照试验注册库、Web of Science、Scopus 和 CINAHL 电子数据库,检索评估 RAS 对脑卒中患者行走影响的研究报告,应用 PICOS 标准纳入研究。

结果

共纳入 21 篇文章(948 例脑卒中幸存者)。根据 PEDro 量表,大多数研究具有较好的方法学质量,但存在较高的偏倚风险。最一致的发现是,与基线和对照组(常规治疗)相比,RAS 可改善所有阶段脑卒中患者的步行和平衡参数。但关于功能性步行和步行辅助器具的使用情况报告并不一致。一些研究还表明,RAS 可能与其他补充疗法(骑马和视觉提示)一样有效。

结论

尽管 RAS 具有有益的效果,但仍存在疑问,即它是否优于其他补充疗法。鉴于干预措施的异质性、对照组的干预措施、不同的持续时间以及不同的结局测量指标,我们建议在解释和推广研究结果时应谨慎。

PROSPERO 注册号:CRD42021277940。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b588/10799424/035ef38a04d0/12906_2023_4310_Fig1_HTML.jpg

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