Gunduz Merve Sevinc, Mustafaoglu Rustem, Ural Ibrahim Halil
From the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakıf University, Istanbul, Türkiye (MSG); Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Türkiye (MSG); Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Türkiye (RM); and Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Beykent University, Istanbul, Türkiye (IHU).
Am J Phys Med Rehabil. 2025 Jun 1;104(6):558-566. doi: 10.1097/PHM.0000000000002674. Epub 2024 Dec 3.
The aim of this study was compare the effects of combined training, which included robot-assisted gait training in addition to traditional balance training, and traditional balance training alone on balance and fear of falling in patients with stroke based on objective assessment methods.
Patients were randomized into combined training group ( n = 21) and traditional balance training group ( n = 21) for duration of 5 wks. Balance were assessed with EncephaLog App recorded stand-up time, sit-down time, and directional sways during walking, Berg Balance Scale, and Timed Up and Go Test. International Fall Efficacy Scale measured fear of falling. Fugl-Meyer Assessment-Lower Extremity assessed limb impairment. Foot posture was assessed with Foot Posture Index.
After the treatments, EncephaLog sways (anterior, medial, lateral: P = 0.04, P = 0.01, P = 0.02), stand-up time ( P = 0.006), sit-down time ( P = 0.002), Berg Balance Scale ( P < 0.001), and International Fall Efficacy Scale ( P = 0.002) improved in combined training group. Timed Up and Go Test ( P = 0.01) and Fugl-Meyer Assessment-Lower Extremity ( P < 0.001) improved in traditional balance training group. Stand-up time ( P = 0.01) and sit-down time ( P = 0.04) showed statistically significant improvement in combined training group compared to traditional balance training group; Fugl-Meyer Assessment-Lower Extremity ( P = 0.002) demonstrated statistically significant improvement in traditional balance training group compared to combined training group.
Objective assessment indicated that combined treatments in subacute and chronic stroke rehabilitation enhance balance and reduce fear of falling more effectively than isolated approaches.
本研究旨在基于客观评估方法，比较联合训练（包括机器人辅助步态训练及传统平衡训练）与单纯传统平衡训练对中风患者平衡能力及跌倒恐惧的影响。
将患者随机分为联合训练组（n = 21）和传统平衡训练组（n = 21），为期5周。使用EncephaLog应用程序记录站立时间、坐下时间以及行走过程中的定向摆动，通过伯格平衡量表和定时起立行走测试评估平衡能力。使用国际跌倒效能量表测量跌倒恐惧。采用Fugl - Meyer下肢评估量表评估肢体损伤情况。使用足姿势指数评估足部姿势。
治疗后，联合训练组的EncephaLog摆动（前、中、侧：P = 0.04，P = 0.01，P = 0.02）、站立时间（P = 0.006）、坐下时间（P = 0.002）、伯格平衡量表（P < 0.001）和国际跌倒效能量表（P = 0.002）均有所改善。传统平衡训练组的定时起立行走测试（P = 0.01）和Fugl - Meyer下肢评估量表（P < 0.001）有所改善。与传统平衡训练组相比，联合训练组的站立时间（P = 0.01）和坐下时间（P = 0.04）有统计学显著改善；与联合训练组相比，传统平衡训练组的Fugl - Meyer下肢评估量表（P = 0.002）有统计学显著改善。
客观评估表明，在亚急性和慢性中风康复中，联合治疗比单一治疗更有效地增强平衡能力并减少跌倒恐惧。
