Symmetrical body-weight distribution training in stroke patients and its effect on fall prevention
Symmetrical body-weight distribution training in stroke patients and its effect on fall prevention
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DOI：
10.1053/apmr.2001.26256
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发表时间：
2001-12-01
影响因子：
4.3
通讯作者：
Tang, FT
中科院分区：
文献类型：
--
作者：
Cheng, PT;Wu, SH;Tang, FT
目的：确定对称体重分布训练在预防中风偏瘫患者福尔斯跌倒中的作用。设计：一项使用站立式生物反馈训练器的前瞻性研究。设置：医院康复单位。患者：54例中风偏瘫患者（训练组30人，对照组24人）。干预措施：传统的中风康复计划，加上对称站立训练和重复的坐立训练，使用站立生物反馈训练器。训练效果通过评估坐立功能和比较两组患者6个月随访时的福尔斯发生率来评价。主要结果测量：福尔斯发生率、坐立功能，包括体重分布、力量上升率和压力中心摆动（COP）。体重在双腿上分布更对称，当起身和坐下时，COP中侧摆动更少。当受试者从椅子上站起来时，左右腿之间体重分布的平均差异显著降低，从体重的49.5% +/- 18.9%降至38.6% +/- 15.8%（p <0.005）。从椅子上站起来时的力量上升率显著增加，从28.3% +/-13.5%BW/s增加到53.6% +/- 20.5%BW/s（p <0.001）。在6个月的随访中，对照组24例患者中有10例（41.7%）跌倒，而训练组30例患者中只有5例（16.7%）跌倒（p <0.05）。结论：对称体重分布训练可以改善坐立能力，从而减少卒中患者的福尔斯次数。
Objective: To determine the role of symmetrical bodyweight distribution training in preventing falls among patients with hemiplegic stroke.Design: A prospective study using a standing biofeedback trainer.Setting: Hospital-based rehabilitation units.Patients: Fifty-four patients with hemiplegic stroke (30 in the training group, 24 in the control group).Interventions: Conventional stroke rehabilitation program, plus symmetrical standing training and repetitive sit-to-stand training, with a standing biofeedback trainer. Training effect was evaluated by assessing the sit-to-stand performance and comparing the occurrence of falls in the 2 groups at a 6-month follow-up.Main Outcome Measures: Occurrence of falls, sit-to-stand performance, including body-weight distribution, rate of rise in force, and sway in center of pressure (COP).Results: Significant improvement in sit-to-stand performance was found in patients in the training group. Body weight was distributed more symmetrically in both legs, with less mediolateral sway in the COP when rising and sitting down. The mean difference in body-weight distribution between the left and right legs while subjects were rising from a chair significantly decreased, from 49.5% +/- 18.9% to 38.6% +/- 15.8% of body weight (BW) (p < .005). The rate of rise in force while rising from a chair significantly increased, from 28.3% +/- 13.5% BW/s to 53.6% +/- 20.5%BW/s (p < .001). At the 6-month follow-up, 10 of 24 patients (41.7%) in the control group had fallen, compared with only 5 of 30 patients (16.7%) in the training group (p < .05).Conclusions: Symmetrical body-weight distribution training may improve sit-to-stand performance and, consequently, decrease the number of falls by stroke patients.