Niewolak Kamila, Antkiewicz Joanna, Piejko Laura, Sobota Grzegorz, Maszczyk Adam, Nawrat-Szołtysik Agnieszka, Opara Józef, Kucio Cezary, Polak Anna
Medical and Rehabilitation Center "Solanki", 88-100 Inowrocław, Poland.
Clinical Department of Physiotherapy in Psychiatry, Faculty of Physical Therapy, Academy of Physical Education in Katowice, 44-200 Rybnik, Poland.
J Clin Med. 2025 Aug 30;14(17):6142. doi: 10.3390/jcm14176142.
After ischemic heart disease, stroke is globally the second leading cause of death and the second most common cause of disability. The rehabilitation of patients with chronic stroke increasingly uses advanced technologies, such as treadmill perturbation-based training (TPBT). While the results of studies with TPBT are promising, they are inconclusive due to the limited number of works and inconsistent research methodologies. Therefore, more randomized clinical trials (RCTs) are needed to evaluate TPBT's efficacy and applicability in post-stroke rehabilitation. This prospective RCT was designed to assess whether and to what extent TPBT can improve postural balance and gait quality and reduce fear of falling in patients with chronic stroke. Fifty individuals who were at least six months post-stroke were enrolled in the trial and randomly assigned to the experimental group (EG; n = 25) to receive the TPBT or the control group (CG; n = 25) to receive overground gait and balance training. Both groups exercised six times per day for three weeks. The Berg Balance Scale showed post-intervention that the postural balance improved significantly in both groups (EG, = 0.001 and CG, = 0.009), but the change did not statistically significantly differentiate the EG from the CG ( = 0.256). The significant improvements in walking speed over the distance of 10 m ( = 0.015) and fear of falling ( = 0.002) in the CG were not significantly different from those in the EG ( = 0.543). TPBT applied to patients with chronic stroke improves their postural control comparably to conventional gait and balance training but does not enhance their gait quality.
在缺血性心脏病之后，中风是全球第二大死因，也是第二大常见残疾原因。慢性中风患者的康复越来越多地采用先进技术，如基于跑步机扰动的训练（TPBT）。虽然TPBT的研究结果很有前景，但由于研究数量有限且研究方法不一致，结果尚无定论。因此，需要更多的随机临床试验（RCT）来评估TPBT在中风后康复中的疗效和适用性。这项前瞻性RCT旨在评估TPBT是否以及在多大程度上可以改善慢性中风患者的姿势平衡和步态质量，并减少跌倒恐惧。50名中风后至少6个月的个体被纳入试验，并随机分配到实验组（EG；n = 25）接受TPBT，或对照组（CG；n = 25）接受地面步态和平衡训练。两组每天锻炼6次，持续3周。Berg平衡量表显示，干预后两组的姿势平衡均有显著改善（EG， = 0.001；CG， = 0.009），但这种变化在统计学上并没有显著区分EG和CG（ = 0.256）。CG组在10米距离内的步行速度（ = 0.015）和跌倒恐惧（ = 0.002）的显著改善与EG组没有显著差异（ = 0.543）。应用于慢性中风患者的TPBT与传统步态和平衡训练相比，能同等程度地改善他们的姿势控制，但并不能提高他们的步态质量。
