An exercise intervention to improve diabetic patients' gait in a real-life environment
An exercise intervention to improve diabetic patients' gait in a real-life environment
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DOI：
10.1016/j.gaitpost.2010.04.013
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发表时间：
2010-06-01
期刊：
影响因子：
2.4
通讯作者：
de Bruin, E. D.
中科院分区：
文献类型：
--
作者：
Allet, L.;Armand, S.;de Bruin, E. D.
目的：糖尿病患者的步态特征和平衡发生改变。对可能的治疗策略知之甚少。本研究评估了一个特定的训练计划对糖尿病患者的步态。方法：一个随机对照试验（N = 71）与干预（IG）（N = 35），对照组（CG）（N = 36）。干预包括体能训练小组训练，包括步态和平衡练习，以功能为导向的加强。结果：干预后，IG在柏油路面上的习惯行走速度增加了0.149 ms（-1）km h（-1）），在鹅卵石上的习惯行走速度增加了0.169 ms（-1）（0.61 km h（-1））。这种显著的治疗效果（p < 0.001）在6个月的随访中略有下降，但仍然显著（p < 0.001）。以类似的方式，在两种地形上观察到节奏、步态周期时间和站立时间的显著改善。在6个月的随访中，除了在柏油地形上的站立时间外，所有结果都保持显著性。在p < 0.004的校正显著性水平下，未观察到对步长和步态周期时间变异系数（任一表面）的显著影响。CG患者的各项参数与基线值相比均保持不变或进行性恶化。讨论：步频对步态速度变化的贡献率为80%，而步长仅为20%。这可能是由于治疗或糖尿病患者的潜力，以调节他们的节奏和步幅length.Conclusion：一个特定的训练计划，可以改善糖尿病患者的步态在真实的生活环境。一个具有挑战性的环境突出治疗效果对患者的步态比均匀焦油表面。(C)2010 Elsevier B. V.保留所有权利。
Aims: Gait characteristics and balance are altered in diabetic individuals. Little is known about possible treatment strategies. This study evaluated the effect of a specific training program on diabetic patients' gait.Methods: A randomized controlled trial (N = 71) with an intervention (IG) (N = 35), and control group (CG) (N = 36). The intervention consisted of physiotherapeutic group training including gait and balance exercises with function-oriented strengthening. Controls received no treatment.Results: After intervention the IG increased their habitual walking speed by 0.149 ms(-1) km h(-1)) on tarred terrain and by 0.169 ms(-1) (0.61 km h(-1)) on the cobblestones. This significant treatment effect (p < 0.001) decreased slightly at the six-month follow-up, but remained significant (p < 0.001). In a similar manner, significant improvement was observed for cadence, gait cycle time and stance time on both terrains. All outcomes except stance time on the tarred terrain remained significant at the six-month follow-up. No significant effect was observed for stride length and the coefficient of variation of gait cycle time (on either surface) at the corrected significance level of p < 0.004. CG patients' parameters all remained unchanged or progressively deteriorated compared to baseline values.Discussion: Cadence contributed 80%, whereas stride length only contributed 20% to the change of gait velocity. This may be due to the treatment or to diabetic patients' potential to regulate their cadence and stride length.Conclusion: A specific training program can improve diabetic patients' gait in a real life environment. A challenging environment highlights treatment effects on patients' gait better than an evenly tarred surface. (C) 2010 Elsevier B.V. All rights reserved.