运动疗法可有效改善脊髓损伤患者的躯干功能和坐位平衡：一项系统评价与荟萃分析。
Exercise therapy can effectively improve trunk performance and sitting balance in spinal cord injury: a systematic review and meta-analysis.
作者信息
Okawara Hiroki, Sawada Tomonori, Onuki Saki, Sugai Keiko, Okubo Toshiki, Ozaki Masahiro, Tsuji Osahiko, Nagoshi Narihito, Sato Yasunori, Nakamura Masaya
机构信息
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Rehabilitation, St. Luke's International Hospital, Tokyo, Japan.
出版信息
Neurol Sci. 2025 Apr;46(4):1581-1597. doi: 10.1007/s10072-024-07960-4. Epub 2024 Dec 30.
OBJECTIVE
To determine the effects of exercise on trunk performance and balance in patients with spinal cord injury (SCI).
METHODS
We searched the databases MEDLINE, Cochrane Library, EMBASE, Physiotherapy Evidence Database, Web of Science, PsycINFO, and CINAHL from inception to June 2020. Our search targeted studies such as randomized or non-randomized controlled trials and randomized crossover trials that evaluated the effects of exercise on trunk performance and balance in patients with SCI.
RESULTS
Seventeen eligible studies with 432 patients with SCI were included in the meta-analysis. The exercise significantly improved several measures: Berg Balance Scale (mean differences [MD] = 4.58; 95% confidence intervals [CI], 0.35, 8.8; p = 0.03), Modified Functional Reach Test (MD = 5.29; 95% CI, 4.16, 6.42; p < 0.01), T-shirt test (MD = 5.62; 95% CI, - 3.82, - 7.42; p < 0.01), Timed Up and Go (MD = - 1.70; 95% CI, - 0.23, - 3.16; p = 0.02). Improvements were also noted in total static sitting balance (standardized mean differences [SMD] = 1.21; 95% CI, 0.79, 1.63; p < 0.01), and total dynamic sitting balance (SMD = 1.01; 95% CI, 0.30, 1.73; p < 0.01). In the subgroup analysis, exercise with sensory input enhancement significantly improved total static (SMD = 1.37; 95% CI, 0.64, 2.11; p < 0.01) and total dynamic sitting balance (SMD = 1.78; 95% CI, 0.28, 3.29; p = 0.02).
CONCLUSIONS
Exercise may improve sitting balance in patients with SCI. Moreover, enhancement of sensory input had an add-on effect in improving sitting balance.
REGISTRATION
PROSPERO (CRD42020185904).
目的
确定运动对脊髓损伤（SCI）患者躯干功能和平衡的影响。
方法
我们检索了MEDLINE、Cochrane图书馆、EMBASE、物理治疗证据数据库、科学网、PsycINFO和CINAHL数据库，检索时间从建库至2020年6月。我们的检索目标是评估运动对SCI患者躯干功能和平衡影响的研究，如随机或非随机对照试验以及随机交叉试验。
结果
17项符合条件的研究共纳入432例SCI患者，进行荟萃分析。运动显著改善了多项指标：伯格平衡量表（平均差[MD]=4.58；95%置信区间[CI]，0.35，8.8；p=0.03）、改良功能性伸展测试（MD=5.29；95%CI，4.16，6.42；p<0.01）、T恤测试（MD=5.62；95%CI，-3.82，-7.42；p<0.01）、定时起立行走测试（MD=-1.70；95%CI，-0.23，-3.16；p=0.02）。在总静态坐姿平衡（标准化平均差[SMD]=1.21；95%CI，0.79，1.63；p<0.01）和总动态坐姿平衡（SMD=1.01；95%CI，0.30，1.73；p<0.01）方面也有改善。在亚组分析中，增强感觉输入的运动显著改善了总静态（SMD=1.37；95%CI，0.64，2.11；p<0.01）和总动态坐姿平衡（SMD=1.78；95%CI，0.28，3.29；p=0.02）。
结论
运动可能改善SCI患者的坐姿平衡。此外，增强感觉输入在改善坐姿平衡方面具有附加作用。
注册信息
PROSPERO（CRD42020185904）
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