A systematic review of the efficacy of gait rehabilitation strategies for spinal cord injury.
A systematic review of the efficacy of gait rehabilitation strategies for spinal cord injury.
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DOI：
10.1310/sci1301-32
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发表时间：
2007-01-01
影响因子：
2.9
通讯作者：
Whittaker, Maura
中科院分区：
文献类型：
--
作者：
Lam, Tania;Eng, Janice J;Whittaker, Maura
目的：系统评价不同康复策略对脊髓损伤后功能性脊髓损伤的疗效。 方法：使用关键词文献检索原始文章，以确定已发表的文献，评价任何治疗或治疗对SCI患者功能性Ambassador的有效性。每项研究的严谨性和质量由两名独立的评审员在标准化量表上进行评分。 结果：检索得到160篇文章，其中119篇因不符合纳入标准而被排除。其余41篇文章涵盖了改善步态的各种策略：体重支持跑步机训练（BWSTT）（n=12）、功能性电刺激（FES）（n=7）、支架/矫形器（n=10）或这些的组合（n=12）。来自随机对照试验的强有力证据表明，在亚急性SCI中，体重支持跑步机训练（BWSTT）后的功能性截肢结果与同等强度的地上步态训练相当。在慢性SCI中，来自前测试/后测试研究的证据表明，BWSTT可能有效地改善功能性Ambal。前测试/后测试或仅后测试研究提供的证据表明，FES可以增强亚急性/慢性SCI的功能性Ambracion，而支具可以为完全SCI患者提供特别的益处，使其能够通过辅助设备站立和走动。 结论：促进步态重复练习的康复策略为亚急性或慢性SCI的功能性截肢提供了最大的益处。支持性器械可增强功能性Ambrosion，特别是在不完全SCI患者中。
OBJECTIVE: To systematically review the evidence for the efficacy of different rehabilitation strategies on functional ambulation following spinal cord injury (SCI). METHODS: A keyword literature search of original articles was used to identify published literature evaluating the effectiveness of any treatment or therapy on functional ambulation in people with SCI. The rigor and quality of each study were scored on standardized scales by two independent reviewers. RESULTS: The search yielded 160 articles, of which 119 were excluded for not meeting our inclusion criteria. The remaining 41 articles covered various strategies for improving gait: bodyweight supported treadmill training (BWSTT) (n=12), functional electrical stimulation (FES) (n=7), braces/orthoses (n=10), or a combination of these (n=12). There is strong evidence from randomized controlled trials that functional ambulation outcomes following body-weight supported treadmill training (BWSTT) are comparable to an equivalent intensity of overground gait training in sub-acute SCI. In chronic SCI, evidence from pre-test/post-test studies shows that BWSTT may be effective in improving functional ambulation. Pre-test/post-test or post-test only studies provide evidence that FES may augment functional ambulation in sub-acute/chronic SCI while braces may afford particular benefits to people with complete SCI to stand up and ambulate with assistive devices. CONCLUSIONS: Rehabilitation strategies that facilitate repeated practice of gait offer the greatest benefits to functional ambulation in sub-acute or chronic SCI. Supportive devices may augment functional ambulation particularly in people with incomplete SCI.