Interactive Sensor-Based Balance Training in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial.
Interactive Sensor-Based Balance Training in Older Cancer Patients with Chemotherapy-Induced Peripheral Neuropathy: A Randomized Controlled Trial.
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作者：
Schwenk M;Grewal GS;Holloway D;Muchna A;Garland L;Najafi B
患有化疗诱导的周围神经病变（CIPN）的癌症患者在感觉和运动技能方面存在缺陷，导致不适当的本体感受反馈，姿势控制受损和高跌倒风险。这项概念验证研究调查了基于可穿戴传感器的交互式运动适应平衡训练计划的可接受性和效果，以改善患有CIPN的老年癌症患者的平衡。22名客观证实CIPN（振动感知阈值，VPT > 25伏）的患者（年龄70.3±8.7岁）被随机分配到干预组（IG）或对照组（CG）。IG接受了基于互动游戏的平衡训练，包括重复的重量转移和虚拟障碍物穿越任务。可穿戴传感器提供来自下肢轨迹的实时视觉/听觉反馈，并允许在每个运动动作期间感知运动错误。对照组未接受任何干预，但建议在家中进行定期锻炼。结果指标是基线和干预后30秒平衡测试期间，随着任务难度的增加（即，站在双脚闭合位置，睁开眼睛（EO）和闭眼（EC），并在EO时处于半串联位置），踝关节、臀部和重心（CoM）在内外（ML）和前后（AP）方向上的摇摆变化。此外，还测量了步态表现（速度、变异性）和跌倒恐惧（国际跌倒疗效量表，FES-I）。尽管参与者的健康状况受损，CIPN严重程度高（VPT=49.6±26.7伏）和高度害怕跌倒（FES-I=35.10±13.78），但培训是安全的，并被广泛接受。干预后，与CG相比，IG在EO（p= 0.010 - 0.022，AP CoM摆动除外）和半串联位置（p= 0.008 - 0.035，踝关节摆动除外）的脚接近位置站立期间，髋关节、踝关节和CoM的摆动显著减少。虽然在IG中观察到EC平衡（8-39%）、步态速度（8%）和FES-I（7%）的改善趋势，但它们没有达到统计学显著性（p>0.05）。这项研究表明，患有CIPN的老年癌症患者可以通过专门定制的基于传感器的运动训练显着改善他们的姿势平衡。该训练方法在目标人群中被广泛接受，并有可能作为改善CIPN相关姿势控制缺陷的治疗方法。然而，未来的研究比较所提出的技术为基础的培训与传统的平衡训练，需要评估的好处，互动关节运动反馈。
Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have deficits in sensory and motor skills leading to inappropriate proprioceptive feedback, impaired postural control and high fall risk. This proof-of-concept study investigated the acceptability and effect of an interactive motor adaptation balance training program based on wearable sensors for improving balance in older cancer patients with CIPN. Twenty-two patients (age 70.3±8.7 years) with objectively confirmed CIPN (Vibration perception threshold, VPT > 25 Volts) were randomized to either intervention (IG) or control (CG) group. The IG received interactive game-based balance training including repetitive weight shifting and virtual obstacle crossing tasks. Wearable sensors provided real-time visual/auditory feedback from lower limb trajectory and allowed perception of motor-errors during each motor-action. The CG received no intervention, while recommended to perform regular exercise at home. Outcome measures were changes in sway of ankle, hip, and center of mass (CoM) in both medio-lateral (ML) and anterior-posterior (AP) directions during 30-second balance tests with increasing task difficulty (i.e. standing in feet-closed-position with eyes open (EO) and eyes closed (EC), and in semi-tandem-position with EO), at baseline and post-intervention. Additionally, gait performance (speed, variability) and fear of falling (Falls-Efficacy-Scale-International, FES-I) were measured. Training was safe and well accepted despite participants’ impaired health status, high severity of CIPN (VPT=49.6±26.7 Volts) and high fear of falling (FES-I=35.10±13.78). Post intervention, sway of hip, ankle, and CoM were significantly reduced in the IG compared to CG during standing in feet-close-position with EO (p=.010–.022, except AP CoM sway) and semi-tandem-position (p=.008–.035, except ankle sway). While improvement trends were observed for balance with EC (8–39%), gait speed (8%), and FES-I (7%) in IG, they did not achieve statistical significance (p>0.05). This study demonstrates that older cancer patients with CIPN can significantly improve their postural balance with specifically tailored, sensor-based exercise training. The training approach is well accepted in the target group and has potential as a therapy for improving CIPN-related postural control deficits. However, future studies comparing the proposed technology-based training with traditional balance training are required to evaluate the benefit of the interactive joint movement feedback.
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影响因子：
4.8
作者：
Bastian AJ
通讯作者：
Bastian AJ
影响因子：
3.5
作者：
Grewal, Gurtej Singh;Schwenk, Michael;Najafi, Bijan
通讯作者：
Najafi, Bijan
DOI：
10.3233/978-1-61499-121-2-103
发表时间：
2012-01-01
期刊：
ANNUAL REVIEW OF CYBERTHERAPY AND TELEMEDICINE 2012: ADVANCED TECHNOLOGIES IN THE BEHAVIORAL, SOCIAL AND NEUROSCIENCES
影响因子：
--
作者：
Lamoth, Claudine J. C.;Alingh, Rolinde;Caljouw, Simone R.
通讯作者：
Caljouw, Simone R.
影响因子：
3.2
作者：
Legters, K
通讯作者：
Legters, K
影响因子：
3.5
作者：
Grewal, Gurtej;Sayeed, Rashad;Najafi, Bijan
通讯作者：
Najafi, Bijan