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目标导向双任务本体感觉训练在亚急性卒中中的有效性:一项回顾性观察研究。

The Effectiveness of Goal-Oriented Dual Task Proprioceptive Training in Subacute Stroke: A Retrospective Observational Study.

作者信息

Chiaramonte Rita, D'Amico Salvatore, Caramma Salvatore, Grasso Giuseppina, Pirrone Simona, Ronsisvalle Maria Giovanna, Bonfiglio Marco

机构信息

Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.

Sant'Agata Rehabilitation Hospital, Catania, Italy.

出版信息

Ann Rehabil Med. 2024 Feb;48(1):31-41. doi: 10.5535/arm.23086. Epub 2024 Feb 28.

Abstract

OBJECTIVE

To show the effectiveness of goal-oriented proprioceptive training in subacute stroke for balance, autonomy, and fall risk.

METHODS

Out a total of 35 patients, consistent in age (75.31±8.65 years), type of stroke (ischemic, 3 to 11 weeks before), and motor impairment, 18 patients underwent solely proprioceptive rehabilitation, the other 17 dual task exercises. The study assessed autonomy using Barthel Index, fall risk with Timed Up and Go Test (TUG), balance through Berg Balance Scale (BBS) and Tinetti test.

RESULTS

After two months, significant improvements were recorded in Barthel Index, BBS (p<0.0001), Tinetti test (p<0.0001 in dual task group, p=0.0029 in single task group), and TUG (p=0.0052 in dual task group, p=0.0020 in single task group) in both groups. Comparing the two groups, dual task group showed a significant difference in Tinetti balance assessment (p=0.0052), between the total score of Tinetti test and TUG in single (p=0.0271), and dual task (p=0.0235). Likewise, Tinetti gait test was significantly related to TUG in single (p=0.0536), and dual task (p=0.0466), while Tinetti balance test to Barthel Index (p=0.0394), BBS (p<0.0001), and TUG in single (p=0.0219), and dual task (p=0.0196). Lastly, there is a positive correlation of the use of aids with BBS (p=0.0074), and total score of Tinetti test (p=0.0160).

CONCLUSION

In subacute stroke, goal-oriented proprioceptive training improved balance, but only partially autonomy. Furthermore, the use of aids after dual-task exercises improved recovery of balance, but did not reduced falls.

摘要

目的

展示目标导向性本体感觉训练在亚急性脑卒中患者中对平衡、自主性及跌倒风险的效果。

方法

共35例患者,年龄(75.31±8.65岁)、脑卒中类型(缺血性,发病3至11周前)及运动障碍程度一致,18例患者仅接受本体感觉康复训练,另外17例进行双任务训练。研究采用巴氏指数评估自主性,用定时起立行走测试(TUG)评估跌倒风险,通过伯格平衡量表(BBS)和Tinetti测试评估平衡能力。

结果

两个月后,两组患者的巴氏指数、BBS(p<0.0001)、Tinetti测试(双任务组p<0.0001,单任务组p=0.0029)及TUG(双任务组p=0.0052,单任务组p=0.0020)均有显著改善。两组比较,双任务组在Tinetti平衡评估(p=0.0052)、单任务组Tinetti测试总分与TUG之间(p=0.0271)以及双任务组之间(p=0.0235)存在显著差异。同样,Tinetti步态测试与单任务组(p=0.0536)和双任务组(p=0.0466)的TUG显著相关,而Tinetti平衡测试与巴氏指数(p=0.0394)、BBS(p<0.0001)以及单任务组(p=0.0219)和双任务组(p=0.0196)的TUG相关。最后,辅助器具的使用与BBS(p=0.0074)和Tinetti测试总分(p=0.0160)呈正相关。

结论

在亚急性脑卒中患者中,目标导向性本体感觉训练改善了平衡,但仅部分改善了自主性。此外,双任务训练后辅助器具的使用改善了平衡恢复,但并未降低跌倒风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95e8/10915301/656602bf163a/arm-23086f1.jpg

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