Retrospective study of effect of whole-body vibration training on balance and walking function in stroke patients

BACKGROUND Dysfunction in stroke patients has been a problem that we committed to solve and explore.Physical therapy has some effect to regain strength,balance,and coordination.However,it is not a complete cure,so we are trying to find more effective treatments.AIM To observe the effect of whole-body vibration training(WVT)on the recovery of balance and walking function in stroke patients,which could provide us some useful evidence for planning rehabilitation.METHODS The clinical data of 130 stroke participants who underwent conventional rehabilitation treatment in our hospital from January 2019 to August 2020 were retrospectively analyzed.The participants were divided into whole-body vibration training(WVT)group and non-WVT(NWVT)group according to whether they were given WVT.In the WVT group,routine rehabilitation therapy was combined with WVT by the Galileo Med L Plus vibration trainer at a frequency of 20 Hz and a vibration amplitude of 0+ACY-plusmn+ADs-5.2 mm,and in the NWVT group,routine rehabilitation therapy only was provided.The treatment course of the two groups was 4 wk.Before and after treatment,the Berg balance scale(BBS),3 m timed up-and-go test(TUGT),the maximum walking speed test(MWS),and upper limb functional reaching(FR)test were performed.RESULTS After 4 wk training,in both groups,the BBS score and the FR distance respectively increased to a certain amount(WVT=46.08±3.41 vs NWVT=40.22±3.75;WVT=20.48±2.23 vs NWVT=16.60±2.82),with P<0.05.Furthermore,in the WVT group,both BBS score and FR distance(BBS:18.32±2.18;FR:10.00±0.92)increased more than that in the NWVT group(BBS:13.29±1.66;FR:6.16±0.95),with P<0.05.Meanwhile,in both groups,the TUGT and the MWS were improved after training(WVT=32.64±3.81 vs NWVT=39.56±3.68;WVT=12.73±2.26 vs NWVT=15.04±2.27,respectively),with P<0.05.The change in the WVT group(TUGT:17.49±1.88;MWS:6.79±0.81)was greater than that in the NWVT group(TUGT:10.76±1.42;MWS:4.84±0.58),with P<0.05.CONCLUSION The WVT could effectively improve the balance and walking function in stroke patients,which may be good for improving their quality of life.

Effects of Pilates exercise on balance, walking and lower limbs motor function in stroke patients: A meta-analysis

Objective: To systematically evaluate the effects of Pilates exercise on balance, walking and lower limbs motor function in stroke patients. Methods: The literature databases such as the Cochrane Library, EMbase, PubMed, Web of Science, Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP) and Wan Fang database (Wan Fang) were retrieved. Randomized controlled trials (RCTs) regarding the effects of Pilates exercise on balance, walking and lower limbs motor function of stroke patients were retrieved. Data were collected and evaluated independently by two researchers. Then, we adopted RevMan 5.3 software to perform a meta-analysis. Results: A total of 5 RCTs were included, including 182 subjects were chosen. The result showed that compared with the routine care group, Pilates exercise can effectively improve the balance of stroke patients when they have trained eight weeks [MD=4.71, 95%CI (2.14, 7.28), P=0.0003], shorten the time of the Timed Up and Go test (TUG)[MD=-1.63, 95%CI (-2.69,-0.56), P=0.003], increase the stride velocity [MD=3.83, 95%CI (1.43, 6.23), P=0.002]. However, the evidence did not support the effectiveness of Pilates exercise on increasing the score of Fugl-Meyer Assessment-Lower Extremity (FMA-LE) of stroke patients [MD=6.70, 95%CI (-3.46, 16.86), P=0.20]. Conclusion: The findings suggest that Pilates could improve the balance and walking speed of stroke patients. However, there still is the lack of the evidence in improving lower limb function. Due to the limitation of the quality of the included studies. highquality studies still should be conducted to investigate the effect of Pilates exercise in stroke patients.

Effect of respiratory muscle training on trunk control and balance ability in stroke patients

Objective: To investigate the effect of respiratory muscle training combined with conventional rehabilitation therapy on trunk control, balance ability and activities of daily living in stroke patients. Methods: Sixty stroke patients were divided into control group and experimental group by random number table, 30 each, and received conventional rehabilitation therapy. Moreover, the experimental group underwent respiratory muscle training (RMT), for four weeks. In each patient, maximal inspiratory pressure (MIP) was measured for the inspiratory muscle strength. Maximal expiratory pressure (MEP) was measured for the expiratory muscle strength. The trunk control was measured using the Trunk Impairment Scale (TIS). The Berg balance scale (BBS) was used to assess the balance function. The modified Barthel index (MBI) was used to evaluate activities of daily living. Results: There were no significant differences in MIP, MEP, TIS, BBS and MBI between the two groups before treatment. The MIP, MEP, TIS, BBS and MBI functions of the control group and the experimental group were improved after treatment, And the functional improvement of the above indicators in the experimental group after treatment was significantly higher than that of the control group. Conclusion: This study proved that RMT improved respiratory muscle strength, trunk control, balance function, and ADL in stroke patients.

Analysis of Functional Capacity and Postural Balance in Former Cutters Cane

Background: Large-scale cane cultivation can promote health impacts of workers, resulting from weight bearing and repetitive movements. Musculoskeletal conditions can alter balance and increase risk of falls. Aim of Work: The objective of this study is to identify clinical characteristics and to correlate balance with functional capacity in ex-cane cutters. Methods: This was a descriptive exploratory study, 42 former workers of the cane cut, with mean age of 49 (±13) years, who were submitted to balance evaluation through the Berg Balance Scale (BSE) and the functional capacity was evaluated by the Incremental Shuttle Walk Test (ISWT). To investigate respiratory symptoms, the Medical Research Council questionnaire was used. Results: The individuals reached a mean of 52 points in BSE, considered low to moderate risk for falls and the average distance traveled of 446.2 (±188.5) meters, corresponding to 52.9% (±23.1) of the normal distance. Weak and negative correlations were found between changes in balance and exposure time (r2-0.16). Conclusion: It is concluded that excessive physical effort contributes to changes in the balance and, consequently, diminish functional capacity.

Effects of a Cordura Material Ankle-Foot Orthosis on Balance Performance in Patients with Foot Drop

As one of the clinical manifestations in patients with hemiplegia after stroke,most of the patients with foot drop suffer from gait disturbance and balance dysfunction, generally accompanied by strephenopodia. There are relatively few researches on the balance ability of patients with foot drop worldwide,while the balance ability will directly affect the walking ability for recovery,so the research is significant in the rehabilitation of foot drop. In the experiment,the Cordura material ankle-foot orthosis （AFO）,one of the world leading technology products,is chosen as the experimental equipment because of its well-known durability and strength. The experiment studied the balance performance of patients with foot drop before and after wearing Cordura material AFO. The Berg scale was evaluated to discuss the effect of the orthosis on balance ability in patients with foot drop. It has been found that the wearing equipment BBS scores were significantly improved. There were significant differences comparing with the control group（ P＆lt;0.05）.But in the course of treatment the Berg balance scale （BBS） scores reduced individually,mainly in terms of leg flexibility.

Underlying Mechanisms of Tai-Chi-Chuan Training for Improving Balance Ability in the Elders

Objective： To compare balance ability between elderly individuals who practiced Tai-Chi-Chuan （TCC） for average 9.64 years and elderly individuals who did not practice TCC and its relationship with lower extremity muscle strength and ankle proprioception. Methods： Twenty-five elderly volunteers were divided into two groups according to their TCC practcing experience. Sixteen were TCC group and the other nine were control population. Subjects completed a static balance test and ankle proprioception test using a custom-designed evaluation system, and concentric and eccentric knee extensor and flexor muscle strength tests. Subjects stood on the plate form to measure the proprioception in functional standing position which was differed from the previous studies. Multiple linear regressions were also used to predict the important factor affecting balance. Results： TCC group performed better than the control group in balance, proprioception, and muscle strength of lower extremity. The proprioception was the most important factor related to balance ability and it can be accounted for explaining 44% of variance in medial-lateral sway direction, and 53% of variance in antero-posterior sway direction. The proprioception may be a more important factor which affecting the balance ability. Conclusion： TCC training is recommended to the elders; as it can improve balance ability through better proprioception.

Study on Walking Ability after Surgery for Proximal Femoral Fracture in Elderly Patients Aged 75 Years or Older

Background: Fractures of the hip are the cause of hospitalization in the geriatric population. In many cases, hip fractures are a sentinel event signaling a systemic decline in the patient’s health. Methods: A retrospective review of the cases of 88 patients aged 75 years or older with proximal femoral fracture was performed. Fracture types, surgical procedures, walking ability before the injury and at discharge, and waiting time from injury to surgery were obtained. Results: No significant difference was observed in walking ability before injury among patients with femoral neck fracture treated with bipolar hip arthroplasty (BHA) or open reduction and internal fixation (ORIF) and those with trochanteric fracture. The degree of deterioration of walking ability was 0.6 in patients treated with BHA, 1.2 in those with neck fracture treated with ORIF, and 1.1 in those with trochanteric fracture. Deterioration was significantly less severe in patients who received BHA, compared with those who received ORIF. Conclusions: Among the patients aged 75 years or older with femoral neck fracture, those who received BHA had a shorter time interval to the start of walking with parallel assist bars or with walking aids, and also had a higher rate of regaining walking ability.

STUDY ON THE INCREASE OF SLOPE-WALKING ABILITY OF MULTI－LEGGED ROBOT

The stable slope-walking ability of legged robot walking in any direction on slope is analysed. The contacting angle and leaving angle of leg to the ground are presented. A method to increase the slope-walking ability is proposed only by changing the contacting angle and leaving angle of the leg to the ground.

BALANCE评定与训练系统对脑卒中患者早期躯干控制能力疗效观察

目的:观察BALANCE评定与训练系统改善脑卒中患者早期躯干控制能力的临床疗效。方法:40例脑卒中患者按照随机数字表法分为治疗组和对照组,每组各20例。2组均给予营养脑神经、改善微循环药物治疗和常规Brunnstrom、Bobath的NDT、Rood、PNF、MRP及躯干肌群力量控制训练等,每周6 d,连续4周。治疗组在此基础上应用BALANCE评定与训练系统进行躯干控制能力训练。治疗前与治疗4周后2组均进行躯干控制测试(TCT)、脑卒中患者姿势评定量表(PASS)检测,应用BALANCE评定与训练系统进行坐位平衡的包络面积及动摇总轨迹长的检测。结果:2组治疗前TCT评分、PASS评分、包络面积、动摇总轨迹长比较,差异无统计学意义(P>0.05);治疗4周后,2组TCT评分、PASS评分较治疗前明显增加,包络面积、动摇总轨迹长明显减少(P<0.05或P<0.01);治疗4周后2组各指标组间比较,差异有统计学意义(P<0.05)。结论:BALANCE评定与训练系统可改善脑卒中患者早期躯干控制能力。

Active Balance Control of Humanoid Locomotion Based on Foot Position Compensation

A foot positioning compensator is developed in this paper for a full-body humanoid to retrieve its balance during continuous walking.An online Foot Position Compensator(FPC)is designed to improve the robustness of biped walking,which can modify predefined step position and step duration online with sensory feedback.Foot placement parameters are learned by the FPC based on the Policy Gradient Reinforcement Learning(PGRL)method.Moreover,the FPC assists the humanoid robot in rejecting external disturbances and recovering the walking position by re-planning the trajectories of walking pattern and the Center of Mass(CoM).An upper body pose control strategy is also presented to further enhance the performance of humanoid robots to overcome strong external disturbances.The advantages of this proposed method are that it neither requires prior information about the walking terrain conditions,nor relies on range sensor information for surface topology measurement.The effectiveness of the proposed method is verified via Webots simulation and real experiments on a full-body humanoid NAO robot.

Effects of Water Weight-Loss Walking Training on Lower Limb Motor Function and Gait in Stroke Patients

Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.

医护一体化模式对前庭外周性眩晕病人眩晕症状及负性情绪的影响

目的:探讨医护一体化模式对前庭外周性眩晕病人的眩晕症状、焦虑抑郁负性情绪的影响。方法:选取2022年10月—2023年3月某三级甲等医院耳鼻咽喉头颈外科行住院治疗的前庭外周性眩晕病人120例,随机分为对照组和试验组,每组60例。对照组实施常规诊疗护理工作模式,试验组实施医护一体化模式,干预2周后观察两组病人的眩晕、平衡状况和焦虑、抑郁负性情绪。结果:干预后两组病人眩晕、平衡状况较干预前均有所改善,两组病人眩晕障碍量表评分、Berg平衡量表评分比较差异均有统计学意义(P<0.05)。负性情绪方面,干预后两组病人较干预前均有所改善,试验组更早缓解了病人焦虑、抑郁情绪(P<0.05)。两组病人负性情绪干预2周后与1周后比较差异无统计学意义(P>0.05)。结论:将医护一体化模式应用于前庭外周性眩晕病人,能更早改善病人眩晕症状,缓解其负性情绪,加快病人康复。

作业疗法联合减重平板步行训练对脑卒中偏瘫患者平衡与功能性步行能力的影响

目的:探讨作业疗法联合减重平板步行训练对脑卒中偏瘫患者平衡与功能性步行能力的影响。方法:选取2019年7月—2021年6月河南科技大学第一附属医院新区医院康复医学科收治的90例脑卒中偏瘫患者作为研究对象,采用随机数表法分为试验组(常规康复护理)与对照组(作业疗法联合联合减重平板步行训练),每组各45例。比较两组患者干预前及干预3个月的平衡功能与功能性步行能力。结果:干预3个月,试验组患者Berg平衡量表(BBS)、功能性步行量表(FAC)评分显著高于对照组,差异有统计学意义(t=23.279、5.555,P<0.05);试验组患者脑卒中专用生活质量量表(SS-QOL)各项评分显著高于对照组,差异有统计学意义(t=8.424、8.637、26.306、5.162、7.579、15.302、8.918、8.080、20.745、10.862、1.397、6.806,P<0.05)。结论:作业疗法联合减重平板步行训练可有效提高脑卒中偏瘫患者平衡功能及功能性步行能力,有利于改善患者的生活质量。

八段锦对中老年膝骨关节炎患者膝关节及平衡能力影响的效果研究

目的:探讨八段锦对中老年膝骨关节炎患者膝关节及平衡能力的影响。方法:选取2021年1~12月在福建中医药大学附属人民医院门诊就诊的70例中老年KOA患者为研究对象,随机分为干预组和对照组各35例,剔除脱落病例,最终干预组30例,对照组31例完成研究。对照组给予常规治疗,干预组在对照组基础上进行12周的八段锦运动干预,比较两组干预前后VAS评分、5次坐立测试时间、闭眼单脚站立时间、“计时-起立-行走”时间及跌倒效能评分。结果:干预前,两组各指标组间差异无统计学意义(P>0.05),干预12周后,干预组VAS评分、5次坐立测试时间和“计时-起立-行走”时间明显低于对照组(P<0.05);闭眼单脚站立时间和跌倒效能评分明显高于对照组(P<0.05)。结论:八段锦运动可有效减轻中老年KOA患者的膝关节疼痛,提高其动、静态平衡能力及跌倒效能水平,对提高患者下肢肌力也有积极作用,是一种相对安全的运动疗法。

肺切除术患者围手术期行走功能受损调查及其影响因素分析

目的 调查肺切除术患者围手术期行走功能受损情况及其影响因素。方法 回顾性分析2017年11月至2020年1月在四川省6家三级医院进行的一个肺癌围手术期症状调查队列(CN-PRO-Lung 1)中的497例患者(四川省肿瘤医院435例,成都市第三人民医院20例,江油市人民医院14例,自贡市第一人民医院13例,成都市第七人民医院8例,大竹县人民医院7例)的临床资料。采用MD安德森症状量表-肺癌子表(MD Anderson Symptom Inventory-Lung Cancer,MDASI-LC)评估患者围手术期行走功能受损的严重程度:2~4分定义为中度行走功能受损,≥5分定义为重度行走功能受损。出院时行走功能有效填写例数为402例。对其采用logistic回归分析确定患者出院时行走功能受损的危险因素。结果 患者术前、术后第1天、出院当天、出院1周和出院4周中重度行走功能受损发生率分别为8.9%、77.6%、53.5%、66.9%和54.8%,重度行走功能受损发生率分别为3.4%、60.0%、20.6%、27.6%和17.3%。多因素logistic回归分析显示,中重度(≥4分)疲劳、疼痛和气短均是患者出院时中重度行走功能受损的独立危险因素(均P<0.05);中重度疲劳、疼痛、气短和咳嗽均是患者出院时重度行走功能受损的独立危险因素(均P<0.05)。结论 积极控制术后症状,可改善接受肺切除术的患者出院时的行走功能,让其尽快回归正常生活和工作。

坐-立位平衡导引训练对老年衰弱前期患者平衡能力的影响

目的探讨坐-立位平衡导引训练改善老年衰弱前期患者平衡能力的效果。方法将80例老年衰弱前期患者采用随机数字表法分为试验组与对照组各40例。对照组按常规进行康复训练,试验组在对照组基础上实施坐-立位平衡导引训练12周。训练4周及12周后,比较两组患者计时起立-行走测试和Berg平衡量表得分。结果训练4周后,试验组的Berg平衡量表得分显著高于对照组(P<0.05);训练12周后,试验组计时起立-行走测试显著短于对照组,Berg平衡量表评分显著高于对照组(均P<0.05)。结论对老年衰弱前期患者开展坐-立位平衡导引训练,有利于缩短患者起立-行走时间,提高其身体平衡能力。

呼吸训练对痉挛型四肢瘫患儿步行耐力及平衡能力的疗效观察

目的探讨呼吸训练对痉挛型四肢瘫(spastic quadriplegia,SP)患儿步行耐力及平衡能力的影响。方法选取2021年11月至2023年11月中国康复研究中心北京博爱医院SP患儿60例,随机分为对照组(n=30)与试验组(n=30)。对照组接受常规康复训练(60 min/次),试验组接受常规康复训练(40 min/次)和呼吸训练(20 min/次);两组训练频率为1次/d,5 d/周,连续4周。分别采用10米步行测试(10-meter work test,10MWT)速度、6分钟步行测试(6-minute walk test,6MWT)距离、Berg平衡量表(Berg balance scale,BBS)评分和肺活量(vital capacity,VC)、用力肺活量(forced vital capacity,FVC)、1秒用力呼气量(forced expiratory volume in first second,FEV1)、呼气峰值流速(peak expiratory flow,PEF)评估患儿训练前后步行耐力、平衡能力和肺功能。结果60例患儿中,男31例、女29例,年龄6~12岁,平均(9.0±1.7)岁。两组性别、年龄、粗大运动功能分级系统(gross motor function classification system,GMFCS)的比较,差异均无统计学意义(P>0.05)。训练4周后,两组患儿的6MWT距离、BBS评分、10MWT速度、FVC、FEV1、PEF均高于训练前,且试验组均高于对照组,差异有统计学意义(P<0.05)。结论呼吸训练能有效改善SP患儿的步行耐力、平衡能力,提高肺功能,增强有氧运动的耐力,降低跌倒风险,提高日常生活质量。

多学科协作制定的行走站立平衡运动康复护理模式在膝关节置换病人中的应用

目的:探究多学科协作制定的行走站立平衡运动康复护理模式在膝关节置换病人中的应用效果。方法:选取2022年1月—2023年4月于医院接受康复治疗的86例膝关节置换病人作为研究对象,按照随机数字表法将病人分为常规组与干预组,各43例。常规组实施常规康复训练,干预组实施多学科协作制定的行走站立平衡运动康复护理方案,两组均持续干预6周,比较干预前后两组病人步行功能[采用计时起立-行走测试(TUGT)、三维步态测试评价]、平衡能力[采用Berg平衡量表(BBS)评价]、膝关节功能[采用美国膝关节协会量表(KSS)评价]以及生活质量[采用世界卫生组织生活质量量表(WHOQOL-100)评价]变化。结果:干预后,两组TUGT计时均缩短(P<0.05),且干预组短于常规组(P<0.05);干预后,两组步速均增快、步幅均增大、患侧支撑相占比均升高(P<0.05),且干预组水平优于常规组(P<0.05);干预后,两组BBS评分,KSS量表中膝关节稳定性、疼痛、行走功能、活动度评分,WHOQOL-100量表中生理、心理、独立性、社会关系、环境、精神状态评分均升高(P<0.05),且干预组评分均高于常规组(P<0.05)。结论:多学科协作制定的行走站立平衡运动康复护理模式应用于膝关节置换病人中,有助于改善病人步行站立功能、肢体平衡功能和膝关节功能,提高病人生活质量。

奥塔戈运动在老年急性脑卒中患者中的应用效果

目的:探讨奥塔戈运动在老年急性脑卒中患者中的应用效果。方法:回顾性选取2022年6月—2023年6月广州市第一人民医院急诊科收治的83例老年急性脑卒中患者为研究对象。根据护理方法的不同将其分为对照组(41例)和观察组(42例)。对照组给予常规护理,观察组在对照组基础上给予奥塔戈运动。比较两组干预前后认知功能、运动功能及平衡能力,干预后依从性及满意度。结果:干预后,两组定向力、记忆、语言、回忆及注意和计算评分均升高,观察组定向力、记忆、语言、回忆及注意和计算评分均高于对照组,差异有统计学意义(P<0.05)。干预后,两组上肢简易Fugl-Meyer运动功能量表(FMA)、下肢FMA、Holden步行功能分级量表(FAC)及Berg平衡量表(BBS)评分均升高,观察组上肢FMA、下肢FMA、FAC及BBS评分均高于对照组,差异有统计学意义(P<0.05)。观察组遵医治疗、定期复查及生活管理依从率和干预方法、服务态度及症状改善满意度均高于对照组,差异有统计学意义(P<0.05)。结论:奥塔戈运动用于老年急性脑卒中患者中,有助于改善患者认知功能,提高运动功能和平衡能力,可获得较高的依从性及满意度。

核心稳定性训练对青少年散打运动员平衡能力和移动能力的影响研究

文章研究目的为探讨核心稳定性训练对青少年散打运动员的平衡能力和快速移动能力的影响,文章采用实验法在经过为期6周核心稳定性训练分析数据后得出结论:(1)核心稳定性训练可以有效提高青少年散打运动员的平衡性,可以提升运动员的躯干稳定性与膝踝关节稳定性。(2)核心稳定性训练可以有效提高青少年散打运动员快速移动的能力,能大大增强运动员在高速运动中做出快速变向与急停的能力,缩短在高速运动同时稳定身体后做出技术动作所需要的时间。