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本体感训练策略与双重任务练习是否能积极影响慢性脑卒中患者的步态参数?系统评价。

Do proprioceptive training strategies with dual-task exercises positively influence gait parameters in chronic stroke? A systematic review.

机构信息

Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Rehabilitation Unit, "AOU Policlinico G. Rodolico-San Marco", Catania, Italy.

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

出版信息

J Rehabil Med. 2024 Aug 15;56:jrm18396. doi: 10.2340/jrm.v56.18396.

Abstract

OBJECTIVE

This study aims to assess the impact of proprioceptive training strategies with dual-task exercises on gait in people with chronic stroke.

STUDY DESIGN

Systematic review.

PATIENTS

Chronic stroke.

METHODS

Searches were conducted in accordance with PRISMA guidelines and PICOS criteria. PubMed, Web of Science, and Scopus databases were systematically searched from November 2020 to February 2022, for eligible clinical trials. Two independent reviewers thoroughly screened potential articles for relevance and assessed the methodology quality. In accordance with the GRADE, PICOS criteria, and Cochrane risk of bias tools, the authors included articles concerning the effectiveness of dual-task in proprioceptive training on gait parameters in people with chronic stroke.

RESULTS

Of 3075 identified studies, 11 articles met the inclusion criteria: 7 were randomized clinical trials, 1 was not randomized, and 3 were observational studies. The overall quality of evidence, assessed using the GRADE framework, was high, indicating a high level of confidence in the systematic review's findings. The papers involved 393 stroke patients; 241 underwent dual-task in proprioceptive training, with 152 participants in other stroke rehabilitation; within the dual-task group, 71 engaged in cognitive tasks, and 170 participated in motor tasks. dual-task in proprioceptive training improved gait speed, cadence, stride time, stride length, and step length. The best effects were observed with training 3 times a week for 4 weeks, with each session lasting 30 minutes, on speed, cadence, stride length, and step length.

CONCLUSION

Current evidence suggests that proprioceptive training strategies with dual-task exercises improved walking abilities in people with chronic stroke. Specifically, it enhanced gait speed, a key indicator of clinical severity.

摘要

目的

本研究旨在评估本体感觉训练策略与双重任务练习对慢性脑卒中患者步态的影响。

研究设计

系统评价。

患者

慢性脑卒中。

方法

根据 PRISMA 指南和 PICOS 标准进行检索。系统检索了 2020 年 11 月至 2022 年 2 月的 PubMed、Web of Science 和 Scopus 数据库,以寻找合格的临床试验。两名独立审查员对潜在文章的相关性进行了彻底筛选,并评估了方法学质量。根据 GRADE、PICOS 标准和 Cochrane 偏倚风险工具,作者纳入了关于双重任务在慢性脑卒中患者本体感觉训练对步态参数影响的有效性的文章。

结果

在 3075 篇鉴定的研究中,有 11 篇文章符合纳入标准:7 篇为随机临床试验,1 篇为非随机,3 篇为观察性研究。使用 GRADE 框架评估的总体证据质量为高,表明对系统评价结果有高度信心。这些论文涉及 393 例脑卒中患者;241 例接受双重任务本体感觉训练,152 例接受其他脑卒中康复治疗;在双重任务组中,71 例进行认知任务,170 例进行运动任务。双重任务本体感觉训练提高了步态速度、步频、步时、步长和步长。每周训练 3 次,每次 30 分钟,对速度、步频、步长和步长的效果最佳。

结论

目前的证据表明,本体感觉训练策略与双重任务练习改善了慢性脑卒中患者的步行能力。具体来说,它提高了步态速度,这是临床严重程度的一个关键指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa87/11337222/1001848e2100/JRM-56-18396-g001.jpg

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