基于体感互动的综合平衡训练对脑卒中偏瘫患者平衡功能的影响
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摘要
目的:探讨基于体感互动的综合平衡训练对脑卒中偏瘫患者平衡能力的影响。方法:35例脑卒中偏瘫患者随机分为体感互动综合平衡训练组(观察组)18例和传统平衡训练组(对照组)17例。对照组进行传统平衡训练,观察组利用体感互动技术,结合任务导向性游戏项目进行平衡训练、躯干控制训练和下肢力量训练的综合平衡训练。治疗期间均配合常规康复治疗。分别在治疗前及治疗4周后进行静动态平衡功能评估。结果:治疗4周后,2组Berg平衡量表(BBS)及Fugl-Meyer运动功能评分(FMA)下肢部分评分均较治疗前明显提高(P<0.01),且观察组更高于对照组(P<0.01,0.05)。治疗后,观察组在睁眼站立、闭眼站立、脚前后站立时重心摆动速度和稳定时间评分均较治疗前及对照组显著降低(P<0.05,0.01),对照组在睁眼站立时重心摆动速度和稳定时间评分与治疗前比较显著降低(P<0.05,0.01),脚前后站立和闭眼站立时重心摆动速度与治疗前比较无显著性差异。结论:基于体感互动的综合平衡训练结合常规平衡训练能更有效的改善脑卒中偏瘫患者的静动态平衡能力。
Objective: To explore the effect of comprehensive balance training based on somatosensory interaction on the balance ability of stroke patients with hemiplegia. Methods: Thirty-five stroke patients with hemiplegia were randomly divided into observation group(n=18) and control group(n=17). The control group was given the traditional balance training. The observation group received balance training, trunk control training and lower limb strength training. The training was done using somatosensory interaction techniques, combined with mission-oriented games. During the treatment, regular rehabilitation treatment was used. Static and dynamic balance function was assessed before and 4 weeks after treatment. Results: After 4 weeks of treatment, BBS and FMA scores of lower limbs in both groups were significantly higher than before(P<0.01), and those in the observation group were higher than in the control group(P<0.01). After treatment, the observation group showed significant improvement in the time of stabilization and the average COP velocity when standing in open eyes, closed eyes, one foot in front(P<0.01). The average COP velocity and the time of stabilization in control group were significantly improved as compared with those before treatment(P<0.05, 0.01). There was no significant difference in the average COP velocity when standing in closed eyes and one foot in front. Conclusion: Comprehensive balance training based on somatosensory interaction combined with routine balance training can more effectively improve the static and dynamic balance function of stroke patients with hemiplegia.
Objective: To explore the effect of comprehensive balance training based on somatosensory interaction on the balance ability of stroke patients with hemiplegia. Methods: Thirty-five stroke patients with hemiplegia were randomly divided into observation group(n=18) and control group(n=17). The control group was given the traditional balance training. The observation group received balance training, trunk control training and lower limb strength training. The training was done using somatosensory interaction techniques, combined with mission-oriented games. During the treatment, regular rehabilitation treatment was used. Static and dynamic balance function was assessed before and 4 weeks after treatment. Results: After 4 weeks of treatment, BBS and FMA scores of lower limbs in both groups were significantly higher than before(P<0.01), and those in the observation group were higher than in the control group(P<0.01). After treatment, the observation group showed significant improvement in the time of stabilization and the average COP velocity when standing in open eyes, closed eyes, one foot in front(P<0.01). The average COP velocity and the time of stabilization in control group were significantly improved as compared with those before treatment(P<0.05, 0.01). There was no significant difference in the average COP velocity when standing in closed eyes and one foot in front. Conclusion: Comprehensive balance training based on somatosensory interaction combined with routine balance training can more effectively improve the static and dynamic balance function of stroke patients with hemiplegia.
引文
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[5] 王鑫,孟兆祥,钱贞,等.丰富平衡训练对脑卒中偏瘫患者平衡功能的影响[J].中国康复,2016,31(6):438-441.
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[9] 窦娜,李丹,马素慧,等.体感交互技术对脑卒中平衡功能和步行功能训练的效果[J].中国康复理论与实践,2014,20(1):66-69.
[10] 王尚书,陈长香,张卫红,等.互动体感游戏对脑卒中患者运动和平衡功能的康复效果[J].中国康复理论与实践,2013,19(7):658-661.
[11] KarimiAA, Naghdi S, Ansari NN.A clinical single blind study to investigate the immediate effects of plantar vibration on balance in patients after stroke[J]. J Bodyw Mov Ther.2018,22(2):242-246.
[12] Park BS,Kim MY,Lee LK,et al. Effects of conventionaloverground gait training and a gait trainer with partial body weightsupport on spatiotemporal gait parameters of patients after stroke.[J]. J Phys Ther Sci.2015,27(5):1603-1607.
[13] In T, Lee K, Song C. Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials[J]. Med Sci Monit. 2016,28(22):4046-4053.
[14] Tyson SF1, SadeghiDE, Nester CJ. The effects of transcutaneous electrical nerve stimulation on strength, proprioception, balance and mobility in people with stroke: a randomized controlled cross-over trial[J].Clin Rehabil. 2013,27(9):785-791.
[15] Yurong M,Peiming C,Le L, et al. Virtual reality training improves balance function[J].Neural Regen Res.2014,9(17): 1628-1634.
[16] Ling C,Wai LAL,Yu RM,et al. Effect of Virtual Reality on Postural and Balance Control in Patients with Stroke: A Systematic Literature Review[J].Biomed Res Int. 2016,20(7)309-322.
[17] Anuja D,Bradford JM,Anouk L,et al.Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review[J].J Neuroeng Rehabil. 2015; 12(1): 46-55.
[18] Levin MF, Weiss PL, Keshner EA.et al. Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles[J]. Phys Ther. 2015,95(3):415-425.
[19] Laver KE1, Lange B, George S. Virtual reality for stroke rehabilitation[J]. Cochrane Database Syst Rev. 2017,20(11):8349-8357.
[20] Fischer A. Environmental enrichment as a method to improve cognitive function. What can we learnfrom animal models [J].Neuroimage. 2016,131(1):42-47.
[21] Cho KH, Lee KJ, Song CH. Virtual-reality balance training with a video-game system improves dynamic balance in chronic stroke patients[J]. Tohoku J Exp Med, 2012; 228(1): 69-74.
[22] Cuthbert JP, Staniszewski K, Hays K,et al. Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury[J].Brain Inj.2014;28(2):181-188.
[23] Kim K,Jung SI,Lee DK.Effectsoftask-oriented circuit training on balance and gait ability in subacute stroke patients: a randomized controlled trial[J].J Phys Ther Sci. 2017,29(6):989-992.
[2] Hahn J,Shin S,Lee W .The effect of modified trampoline trainingon balance,gait,and falls efficacy of stroke patients[J]. J Phys Ther Sci. 2015,27(11):3351-3354.
[3] Kairy D,Veras M,Archambault P,et al.Maximizing post-stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home:study protocol of a randomized clinical trial[J].Contemp Clin Trials.2016,47(1):49-53.
[4] 康海燕,许光旭.虚拟现实技术对脑卒中患者平衡及步行能力康复效果的meta分析[J].中国康复医学杂志,2016,31(5):554-557.
[5] 王鑫,孟兆祥,钱贞,等.丰富平衡训练对脑卒中偏瘫患者平衡功能的影响[J].中国康复,2016,31(6):438-441.
[6] Lee MM, Lee KJ, Song CH.Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke[J]. Med Sci Monit. 2018, 27(24):2590-2598.
[7] Lee Y, Choi W, Lee K, et al.Virtual Reality Training With Three-Dimensional Video Games Improves Postural Balance and Lower Extremity Strength in Community-Dwelling Older Adults[J].J Aging Phys Act. 2017,25(4):621-627.
[8] 代艾波,瞿畅,朱小龙,等.体感交互技术在运动康复领域的应用[J].中国康复理论与实践,2014,20(1):41-45.
[9] 窦娜,李丹,马素慧,等.体感交互技术对脑卒中平衡功能和步行功能训练的效果[J].中国康复理论与实践,2014,20(1):66-69.
[10] 王尚书,陈长香,张卫红,等.互动体感游戏对脑卒中患者运动和平衡功能的康复效果[J].中国康复理论与实践,2013,19(7):658-661.
[11] KarimiAA, Naghdi S, Ansari NN.A clinical single blind study to investigate the immediate effects of plantar vibration on balance in patients after stroke[J]. J Bodyw Mov Ther.2018,22(2):242-246.
[12] Park BS,Kim MY,Lee LK,et al. Effects of conventionaloverground gait training and a gait trainer with partial body weightsupport on spatiotemporal gait parameters of patients after stroke.[J]. J Phys Ther Sci.2015,27(5):1603-1607.
[13] In T, Lee K, Song C. Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials[J]. Med Sci Monit. 2016,28(22):4046-4053.
[14] Tyson SF1, SadeghiDE, Nester CJ. The effects of transcutaneous electrical nerve stimulation on strength, proprioception, balance and mobility in people with stroke: a randomized controlled cross-over trial[J].Clin Rehabil. 2013,27(9):785-791.
[15] Yurong M,Peiming C,Le L, et al. Virtual reality training improves balance function[J].Neural Regen Res.2014,9(17): 1628-1634.
[16] Ling C,Wai LAL,Yu RM,et al. Effect of Virtual Reality on Postural and Balance Control in Patients with Stroke: A Systematic Literature Review[J].Biomed Res Int. 2016,20(7)309-322.
[17] Anuja D,Bradford JM,Anouk L,et al.Efficacy of virtual reality-based intervention on balance and mobility disorders post-stroke: a scoping review[J].J Neuroeng Rehabil. 2015; 12(1): 46-55.
[18] Levin MF, Weiss PL, Keshner EA.et al. Emergence of virtual reality as a tool for upper limb rehabilitation: incorporation of motor control and motor learning principles[J]. Phys Ther. 2015,95(3):415-425.
[19] Laver KE1, Lange B, George S. Virtual reality for stroke rehabilitation[J]. Cochrane Database Syst Rev. 2017,20(11):8349-8357.
[20] Fischer A. Environmental enrichment as a method to improve cognitive function. What can we learnfrom animal models [J].Neuroimage. 2016,131(1):42-47.
[21] Cho KH, Lee KJ, Song CH. Virtual-reality balance training with a video-game system improves dynamic balance in chronic stroke patients[J]. Tohoku J Exp Med, 2012; 228(1): 69-74.
[22] Cuthbert JP, Staniszewski K, Hays K,et al. Virtual reality-based therapy for the treatment of balance deficits in patients receiving inpatient rehabilitation for traumatic brain injury[J].Brain Inj.2014;28(2):181-188.
[23] Kim K,Jung SI,Lee DK.Effectsoftask-oriented circuit training on balance and gait ability in subacute stroke patients: a randomized controlled trial[J].J Phys Ther Sci. 2017,29(6):989-992.
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