视觉反馈平衡训练仪训练对脑卒中后平衡及步行能力影响的Meta分析

    Effect of Visual-Feedback Balance Training on Balance and Walking Ability after Stroke: A Meta-Analysis

    • 摘要: 目的 系统评价视觉反馈平衡训练仪训练对脑卒中患者平衡能力、步行能力以及日常生活能力的康复疗效。 方法 计算机检索PubMed、Web of Science、EMBASE、Cochrane 图书馆、中国知网、万方、维普中文科技期刊全文等国内外数据库从建库到2018年4月的有关文献,收集视觉反馈平衡训练仪训练对脑卒中患者平衡及步行能力影响的临床随机对照试验,并运用RevMan 5.3软件对符合纳入标准的所有结果进行Meta分析。 结果 最后选入12篇文献共565例患者。Meta分析结果显示: 视觉反馈平衡仪训练组与常规平衡训练组平衡量表评分12篇文献合并效应量均数差=6.49,95%可信区间5.63~7.35,Z=14.77,P<0.000 01,两组差异有统计学意义;视觉反馈平衡仪训练组与常规平衡训练组“起立-行走”计时6篇文献合并效应量均数差=-3.91,95%可信区间-4.68~-3.14,Z=9.97,P<0.000 01,两组差异有统计学意义;视觉反馈平衡仪训练组与常规平衡训练组日常生活能力量表评分2篇文献合并效应量均数差=5.58,95%可信区间2.31~8.84,Z=3.35,P=0.000 8,两组差异有统计学意义。 结论 视觉反馈平衡训练仪训练能有效增强脑卒中患者的站位平衡功能并改善他们的步行能力与日常生活活动能力,且较传统平衡训练改善更明显。但是目前与平衡仪训练相关的高水平的临床研究较少,故需要进行大样本量的临床随机对照试验来证实其有效性。

       

      Abstract: Objective To systematically review the effect of visual-feedback balanced training on balance, walking and daily living after stroke. Methods Randomized controlled trials (RCTs) about balance training instrument for balance and walking ability of stroke were electronically searched in PubMed, Web of Science, EMBASE, the Cochrane library, China National Knowledge Infrastructure,Wanfang Data, VIP Database for Chinese Technical Periodicals from the date of establishment to April 2018. Using RevMan 5.3 software to analyze all the results that conform to the standard by meta. Results A total of 565 patients of 12 RCTs were included. The results of meta analysis showed that after treatment, the Berg balance scale scores of 12 articles of balancing instrument training group and conventional balance training group with effect of the amount of MD=6.49, 95%CI 5.63~7.35, Z=14.77,P<0.000 01, the two groups have significant difference. The “Up & Go test”of 6 articles of balancing instrument training group and conventional balance training group with effect of the amount of MD=-3.91,95%CI -4.68~-3.14,Z=9.97,P<0.000 01, the two groups have significant differerce. The modify Barthel scores of balancing instrument training group and conventional balance training group with effect of the amount of MD=5.58, 95%CI 2.31~8.84, Z=3.35,P=0.000 8, the two groups have significant difference. Conclusion Balanced training instrument exercises effectively enhance the balance function of stroke patients, improve their walking function and their daily living ability, and it is more obvious than traditional balance training. However, there are few high level clinical studies related to the training of balance instrument, so a large sample of clinical randomized controlled trials is needed to verify its effectiveness.

       

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