踝关节活动对慢性脑卒中幸存者背屈范围和步态参数的影响:一项系统回顾和荟萃分析

Hariharasudhan Ravichandran, Balamurugan Janakiraman
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引用次数: 3

摘要

背景:踝关节背屈运动受限是大多数慢性脑卒中幸存者的常见表现。踝关节周围痉挛和结缔组织改变,限制背屈,干扰平衡和步态表现。提高背屈的功能范围是卒中后康复的必要条件。目的:本荟萃分析分析了踝关节活动技术在改善慢性卒中幸存者背屈范围和步态参数方面的作用。方法:在CINAHL、PubMed、Embase、PsyINFO和OpenGrey中检索截至2020年7月发表的文章。我们纳入了以背屈活动范围(ROM)和步态参数为结果的评估慢性卒中受试者踝关节活动效果的随机对照试验(RCTs)的英文版。提取了参与者的特征、干预措施、结果测量和变异性测量。纳入试验的方法学质量采用PEDro量表和Cochrane协作工具评估偏倚风险。采用随机效应模型计算背屈ROM、步态速度、步长、步频和up and go (TUG)的合并标准化平均差。结果:8项随机对照试验纳入226例卒中患者,PEDro平均方法学评分为6分(满分10分),符合本荟萃分析。踝关节活动对被动背屈ROM、步态速度、步长(受影响侧)和节奏结果有统计学上的显著改善。步长(未受影响侧)和TUG均无统计学意义。结论:踝关节活动技术可有效改善慢性脑卒中幸存者被动背屈ROM、步态速度和节奏。然而,踝关节活动对脑卒中患者的保留作用尚不清楚。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of Ankle Joint Mobilization on Dorsiflexion Range and Gait Parameters in Chronic Stroke Survivors: A Systematic Review and Meta-analysis
Background: Ankle dorsiflexion movement restriction is a common presentation in most of the chronic stroke survivors. Spasticity and connective tissue changes around ankle, limits dorsiflexion, and interferes with balance and gait performances. Improving functional range of dorsiflexion is essential in post-stroke rehabilitation. Objectives: This meta-analysis analyzed the effects of ankle mobilization techniques in improving dorsiflexion range and gait parameters among chronic stroke survivors. Method: Articles published up to July 2020 were searched in CINAHL, PubMed, Embase, PsyINFO, and OpenGrey. English version of randomized controlled trials (RCTs) assessing the effects of ankle joint mobilization among chronic stroke subjects, with dorsiflexion range of motion (ROM) and gait parameters as outcome, were included. Characteristics of participants, interventions, outcome measure, and measures of variability were extracted. Methodological quality of included trials was assessed using PEDro scale and Cochrane Collaboration tool for the risk of bias. Pooled standardized mean difference was calculated using random effects model for dorsiflexion ROM, gait velocity, step length, cadence, and timed up and go (TUG). Results: Eight RCTs including 226 stroke patients, with mean methodological score of 6 out of 10 in PEDro, were eligible for this meta-analysis. Ankle joint mobilization demonstrated statistically significant improvement on passive dorsiflexion ROM, gait velocity, step length (affected side), and cadence outcomes. Nonsignificance was found in step length (unaffected side) and in TUG. Conclusion: The ankle mobilization techniques are effective in improving passive dorsiflexion ROM, gait velocity, and cadence in chronic stroke survivors. However, the retention effect of ankle mobilization among stroke subjects is not known.
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