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一项针对中风患者进行姿势控制和运动恢复的、包含功能性本体感觉刺激的康复计划的有效性:一项双盲、随机、对照试验。

Effectiveness of a rehabilitation program involving functional proprioceptive stimulation for postural control and motor recovery among stroke patients: a double-blinded, randomized, controlled trial.

作者信息

Wiśniowska-Szurlej Agnieszka, Leszczak Justyna, Brożonowicz Justyna, Ciąpała Gabriela, Hernández-Lázaro Héctor, Sozańska Agnieszka

机构信息

Faculty of Health Sciences and Psychology, Collegium Medicum, University of Rzeszow, Rzeszow, 35-310, Poland.

Donum Corde Rehabilitation and Medical Care Center, Budy Głogowskie 835B Street, Głogów Małopolski, 36-060, Poland.

出版信息

J Neuroeng Rehabil. 2025 Jul 4;22(1):147. doi: 10.1186/s12984-025-01678-w.

Abstract

BACKGROUND

Early and intensive rehabilitation is particularly important for increasing neuroplasticity in patients after stroke. The aim of this study was to evaluate the effects of a 4-week rehabilitation program involving functional proprioceptive stimulation (FPS) on postural control and functional recovery in patients with stroke.

METHODS

This double-blinded, randomized controlled trial (RCT) was conducted at a tertiary care rehabilitation centre. Fifty patients with first stroke were recruited and randomly separated into a FPS Group ( = 25) or Sham Group ( = 25). Both groups underwent 3.5 h of rehabilitation, including physiotherapy, occupational therapy, verticalization and focal vibration on specific myotendinous junctions of the leg, for 5 days a week over 4 successive weeks. For the sham group, the focal vibrations had an amplitude of 0.1 mm with a fixed frequency of 40 Hz. For the FPS group, the stimulation consisted of focal vibrations of an amplitude of 2 mm with frequencies constantly changing between 40 and 85 Hz. Postural control evaluation was performed with the Berg Balance Scale (BBS), Functional Reach Test (FRT) and via the Alfa AC International East stabilometric platform; motor recovery was examined via the Barthel Index (BI) and ICF Rehabilitation Set. All assessments were performed at baseline and after intervention.

RESULTS

Following the intervention, the FPS Group demonstrated clinically significant improvements in postural control and functional status (BBS  = 0.041 and BI  = 0.037). A statistically significant improvement was also obtained in the Sham Group in the FTR test. Patients in the FPS Group experienced significantly greater improvement than those in the Sham Group on D420 (transferring oneself) and D640 (performing housework activities).

CONCLUSIONS

Our study showed that conventional rehabilitation and rehabilitation combined with functional proprioceptive stimulation both improve balance and functional efficiency in people after.

TRIAL REGISTRATION

The study was registered at ClinicalTrials.gov (NCT05550987).

摘要

背景

早期强化康复对于增加中风患者的神经可塑性尤为重要。本研究的目的是评估一项为期4周、涉及功能性本体感觉刺激(FPS)的康复计划对中风患者姿势控制和功能恢复的影响。

方法

这项双盲随机对照试验(RCT)在一家三级护理康复中心进行。招募了50例首次中风患者,并随机分为FPS组(n = 25)或假手术组(n = 25)。两组均接受3.5小时的康复治疗,包括物理治疗、职业治疗、直立训练以及对腿部特定肌腱结合处进行局部振动,连续4周,每周5天。对于假手术组,局部振动的振幅为0.1毫米,固定频率为40赫兹。对于FPS组,刺激包括振幅为2毫米、频率在40至85赫兹之间不断变化的局部振动。使用伯格平衡量表(BBS)、功能性伸展测试(FRT)并通过Alfa AC International East稳定测量平台进行姿势控制评估;通过巴氏指数(BI)和国际功能、残疾和健康分类康复集评估运动恢复情况。所有评估均在基线和干预后进行进行。

结果

干预后,FPS组在姿势控制和功能状态方面表现出临床上的显著改善(BBS = 0.041,BI = 0.037)。假手术组在FTR测试中也取得了统计学上的显著改善。在D420(自我转移)和D640(进行家务活动)方面,FPS组患者的改善明显大于假手术组。

结论

我们的研究表明,传统康复以及与功能性本体感觉刺激相结合的康复均能改善中风患者的平衡和功能效率。

试验注册

该研究已在ClinicalTrials.gov(NCT05550987)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/337d/12231709/937cde5498e5/12984_2025_1678_Figa_HTML.jpg

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