Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis
Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis
复制标题
DOI：
10.1016/j.apmr.2007.12.039
复制
发表时间：
2008-08-01
影响因子：
4.3
通讯作者：
Deutsch, Judith
中科院分区：
文献类型：
--
作者：
Dunsky, Ayelet;Dickstein, Ruth;Deutsch, Judith
目的：测试家庭运动想象步态训练计划的可行性和有效性，以改善慢性中风后偏瘫患者的步行能力。设计：非随机对照试验。地点：当地设施。参与者：参与者（N = 17）是社区居民志愿者，患有至少 3 个月前发生的单侧中风引起的偏瘫。干预：参与者在家中接受 15 分钟的监督想象步态训练每周 3 天，持续 6 周。该干预措施解决了受影响下肢的步态障碍和特定任务的步态训练。在干预前、干预开始后3周和6周以及3周随访时，通过运动学和功能量表两次评估步行能力。主要指标：时空、运动学和功能性步行测量。结果：训练后步行速度显着提高40%，并且在3周随访时基本保持了这种增益。干预措施对步行速度的影响大小适中 (0.64)。受影响下肢的步幅、步频和单支撑时间显着增加，而双支撑时间减少。Tinetti 性能导向活动评估的步态量表以及功能步态也有所改善。 65% 的参与者在改良功能步行类别指数中进步了 1 个步行类别。结论：虽然建议进一步研究，但研究结果支持可行性，并证明结合家庭运动想象练习来提高中风后偏瘫的步行技能是合理的。
Objective: To test the feasibility and efficacy of a home-based motor imagery gait training program to improve walking performance of individuals with chronic poststroke hemiparesis.Design: Nonrandomized controlled trial.Setting: Local facility.Participants: Participants (N=17) were community-dwelling volunteers with hemiparesis caused by a unilateral stroke that occurred at least 3 months before the study.Intervention: Participants received 15 minutes of supervised imagery gait training in their homes 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task-specific gait training. Walking ability was evaluated by kinematics and functional scales twice before the intervention, 3 and 6 weeks after the intervention began, and at the 3-week follow-up.Main Outcome Measures: Spatiotemporal, kinematic, and functional walking measurements.Results: Walking speed increased significantly by 40% after training, and the gains were largely maintained at the 3-week follow-up. The effect size of the intervention on walking speed was moderate (.64). There were significant increases in stride length, cadence, and single-support time of the affected lower limb, whereas double-support time was decreased, Improvements were also noted on the gait scale of the Tinetti Performance-Oriented Mobility Assessment as well as in functional gait. Sixty-five percent of the participants advanced 1 walking category in the Modified Functional Walking Categories Index.Conclusions: Although further study is recommended, the findings support the feasibility and justify the incorporation of home-based motor imagery exercises to improve walking skills for poststroke hemiparesis.