认知-运动双任务训练对脑卒中恢复期患者平衡功能和步态效果的随机对照试验
Effect of cognitive-motor dual-task training on balance function and gait in convalescent stroke patients:a ran-domized contolled trial
李冬 1张皓 2刘楠 3王昕悦 3徐淼3
作者信息
- 1. 首都医科大学康复医学院,北京市 100068;北京市普仁医院康复医学科,北京市 100062
- 2. 首都医科大学康复医学院,北京市 100068;中国康复研究中心北京博爱医院神经康复三科,北京市 100068;康复大学,山东青岛市 266071;山东大学齐鲁医学院,山东济南市 250063
- 3. 北京市普仁医院康复医学科,北京市 100062
- 折叠
摘要
目的 探讨认知-运动双任务训练对脑卒中后6个月内患者平衡功能和步态的影响.方法 2022年5月至2023年4月,北京市普仁医院脑卒中恢复期患者68例,随机分为对照组和试验组,每组34例.两组均接受常规康复训练,在此基础上,对照组进行单任务步行训练,试验组进行认知-步行双任务训练,共4周.治疗前后进行Fugl-Meyer评定量表下肢部分(FMA-LE)评定,采用平衡测试仪测量单任务和双任务状态下静态平衡姿势轨迹和稳定极限;采用步态分析仪进行步态分析.结果 训练后,两组FMA-LE评分均显著增加(|t|>10.239,P<0.001),两组间比较无显著性差异(P>0.05).单任务状态下,训练后两组平衡测试各参数均明显提高(|t|>2.934,P<0.01),试验组闭眼运动轨迹长度明显长于对照组(t=3.330,P=0.001);两组步态分析各参数均改善(|t|>6.823,P<0.05),试验组步速优于对照组(t=2.355,P=0.022).双任务状态下,训练后除对照组睁眼状态下运动轨迹长度无明显变化(P>0.05),两组其他平衡测试参数均改善(|t|>2.472,P<0.05),两组间所有参数比较均无显著性差异(P>0.05);两组步态分析各参数均改善(|t|>2.238,P<0.05),试验组步幅、步速优于对照组(t>2.443,P<0.05).结论 认知-运动双任务训练可以有效改善恢复期脑卒中患者下肢运动功能、平衡功能和步行能力,在改善步态部分参数方面优于单任务步行训练.
Abstract
Objective To investigate the effect of cognitive-motor dual-task training on balance and gait in patients within six months post stroke.Methods From May,2022 to April,2023,68 stroke patients in Beijing Puren Hospital were randomly divided into con-trol group(n=34)and experimental group(n=34).Both groups received conventional rehabilitation training.The control group received single-task walking training,and the experimental group received cognitive-walking dual-task training,in addition,for four weeks.They were assessed with Fugl-Meyer Assessment-Lower Extremi-ties(FMA-LE)before and after training,and measured static balance posture trajectory,stability limits,gait anal-ysis with Pro-kin and OptoGait in both single-task and dual-task states.Results After training,the scores of FMA-UE increased in both groups(|t|>10.239,P<0.001),and no difference was found between two groups(P>0.05).In single-task state,all the parameters of balance improved in both groups after training(|t|>2.934,P<0.01),and the length of movement locus with eyes closed was longer in the experi-mental group than in the control group(t=3.330,P=0.001);all the parameters of gait improved in both groups after training(|t|>6.823,P<0.05),and the walk speed was better in the experimental group than in the control group(t=2.355,P=0.022).In dual-task state,all the parameters of balance improved in both groups after train-ing(|t|>2.472,P<0.05),expect the length of trajectory with eyes open in the control group(P>0.05),and no difference was found in other parameters between two groups(P>0.05);and all the parameters of gait improved in both groups after training(|t|>2.238,P<0.05),and the stride length and walk speed were better in the experi-mental group than in the control group(t>2.443,P<0.05).Conclusion Cognitive-motor dual-task training can effectively improve lower limb motor function,balance function and walking ability in convalescent stroke patients,and it is superior to single-task walking training in improving some gait parameters.
关键词
脑卒中/认知/运动/双任务训练/平衡/步态/随机对照试验Key words
stroke/congnition/motor/dual-task training/balance/gait/randomized contolled trial引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据