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平衡训练对平衡能力降低的中风患者的安全性和有效性:随机对照试验的荟萃分析

The Safety and Efficacy of Balance Training on Stroke Patients With Reduced Balance Ability: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Kim Yong Wook, Yoon Seo Yeon

机构信息

Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Brain Neurorehabil. 2024 Oct 22;17(3):e15. doi: 10.12786/bn.2024.17.e15. eCollection 2024 Nov.

Abstract

To investigate the safety and efficacy of balance training for stroke patients with reduced balance ability by performing a meta-analysis of randomized controlled trials. The PubMed, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to February 2022. Quality assessment was performed using the using the Cochrane risk of bias tool. Studies were included if: 1) patient allocation was randomized; 2) the participant was composed of stroke patients with reduced balance ability (Berg Balance Scale [BBS] ≤ 40, Timed-Up and Go ≥ 14 seconds, or Mini-Balance Evaluation Systems Test ≤ 17.5); and 3) intervention was additional balance training for the experimental group. Six studies including 466 patients were included in the final analysis. The meta-analysis showed a significant improvement in the BBS (mean difference [MD], 8.14; 95% confidence interval [CI], 4.65, 11.64) and Trunk Impairment Scale (MD, 4.71; 95% CI, 3.45, 5.96) after balance training relative to the comparison group. Ambulation function was significantly improved (standardized MD, 0.98; 95% CI, 0.46, 1.49) after balance training. There was one report of a femur fracture among 230 participants in the balance training group. Balance training in addition to conventional rehabilitation program in stroke patients with reduced balance ability appears to be effective and safe.

摘要

通过对随机对照试验进行荟萃分析,探讨平衡训练对平衡能力下降的中风患者的安全性和有效性。检索了截至2022年2月的PubMed、Embase和Cochrane对照试验中央注册库数据库。使用Cochrane偏倚风险工具进行质量评估。纳入研究的条件为:1)患者分配是随机的;2)参与者由平衡能力下降的中风患者组成(伯格平衡量表[BBS]≤40、定时起立行走试验≥14秒或迷你平衡评估系统测试≤17.5);3)干预措施为实验组额外进行平衡训练。最终分析纳入了6项研究,共466例患者。荟萃分析显示,与对照组相比,平衡训练后BBS(平均差[MD],8.14;95%置信区间[CI],4.65,11.64)和躯干功能障碍量表(MD,4.71;95%CI,3.45,5.96)有显著改善。平衡训练后步行功能显著改善(标准化MD,0.98;95%CI,0.46,1.49)。平衡训练组的230名参与者中有1例股骨骨折报告。对于平衡能力下降的中风患者,在传统康复方案基础上进行平衡训练似乎是有效且安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01f1/11621668/79520a13fef7/bn-17-e15-g001.jpg

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