特定步态负重干预对脑卒中患者体能表现的影响:系统回顾和荟萃分析

Hariharasudhan Ravichandran, Kshama Shetty, Balamurugan Janakiraman
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引用次数: 1

摘要

背景:在中风幸存者中,不对称负重导致的姿势不稳定、步态功能障碍和跌倒倾向限制了平衡和活动功能。对称负重对中风后恢复活动功能至关重要。提高对称负重的策略仍然是中风康复的挑战。目的探讨负重干预对脑卒中患者运动能力的改善效果。方法筛选PubMed、护理和相关健康文献累积索引(Cumulative Index for Nursing and Allied Health Literature)、物理治疗证据数据库(PEDro)、Google Scholar和OpenGrey 5个数据库,确定从研究开始到2022年已发表和未发表的研究。采用客观或自我报告的身体功能作为结果工具,研究对称负重干预对中风受试者的影响。10篇1b级证据的文章平均PEDro得分为6.4。这些文章的偏倚风险是中等的。结果共纳入10篇文章276名受试者。使用9篇文章进行的荟萃分析报告,特定步态负重改善平衡和步态速度,总体效应值为1.35(95%可信区间:0.88-1.81)和0.66(95%可信区间:0.20-1.13)。然而,步长(0.51)、步幅(0.26)和跌倒效能量表(0.21)的效应值均未显示显著改善。结论:本荟萃分析表明,特定步态的负重策略对改善平衡和步行速度有效,但对步态的其他参数和跌倒风险没有改善。这些策略可用于改善康复环境中无法获得康复技术援助的中风受试者的对称负重。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Gait-Specific Weight-Bearing Interventions on Physical Performance Among Subjects with Stroke: A Systematic Review and Meta-analysis
Background Postural instability, gait dysfunctions, and tendency to fall resulting from asymmetrical weight-bearing restrict balance and mobility functions among stroke survivors. Symmetrical weight-bearing is essential for restoring mobility functions following stroke. Strategies to improve symmetrical weight-bearing remain a challenge in stroke rehabilitation. Objective To explore the evidence regarding the effectiveness of weight-bearing interventions to improve physical performance among subjects with stroke. Methods Five databases, including PubMed, Cumulative Index for Nursing and Allied Health Literature, Physiotherapy Evidence Database (PEDro), Google Scholar, and OpenGrey, were screened for identifying published and unpublished studies from their inception and up to 2022. Studies investigating the effect of symmetrical weight-bearing interventions among stroke subjects using objective or self-reporting of physical function as an outcome tool were included. Ten articles with grade 1b level of evidence demonstrated an average PEDro score of 6.4. The risk of bias was moderate among the articles. Results Ten articles with 276 participants were included in this review. Meta-analysis performed using 9 articles report that gait-specific weight-bearing improved balance and gait velocity with an overall effect size of 1.35 (95% confidence interval: 0.88–1.81) and 0.66 (95% confidence interval: 0.20–1.13). However, the effect size of step length (0.51), cadence (0.26), and fall efficacy scale (0.21) indicates nonsignificant improvement. Conclusions This meta-analysis suggests that gait-specific weight-bearing strategies are effective in improving balance and speed of walking but did not improve other parameters of gait and risk of fall. These strategies could be used to improve the symmetrical weight-bearing of stroke subjects in rehabilitation settings who do not have access to technological assistance in rehabilitation.
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