跑步机步态训练对深部脑刺激后帕金森患者平衡能力的影响。

IF 0.5 4区 医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243203e266917
Viviane Carolina Sales de Andrade, Angelica Castilho Alonso, Natalia Mariana Silva Luna, Fernanda Botta Tarallo Rogatto, Guilherme Carlos Brech, Danilo Sales Bocalini, Júlia Maria D'Andrea Greve
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引用次数: 0

摘要

目的:帕金森病(PD)患者在接受脑深部刺激(DBS)治疗后,通常仍会出现明显的步态和姿势稳定性问题,因此需要额外的干预措施。因此,我们的目的是评估有体重支持和无体重支持的跑步机训练对 DBS 后帕金森病患者平衡能力的比较效果:方法:对 11 名使用双侧丘脑下核 DBS 的帕金森病患者进行了评估,评估方法包括 "向上走时间测试(TUG)"、"Berg 平衡量表(BBS)"和 "静态后座力测量法(Static Posturography)"。在第一阶段,所有受试者都参加了为期 8 周的跑步机训练,同时接受常规物理治疗。六周后(冲出),每位患者再参加为期八周的部分体重支持的跑步机训练:第一阶段结束后,患者的认知能力 TUG 表现有所改善(训练前:15.7 ± 1.8 秒;训练后:13.7 ± 3.1 秒;P < 0.01),闭眼时身体的前后摆动和内外侧摆动也有所增加。第二阶段后,常规(前:12.3 ± 2.0 秒;后:10.7 ± 1.7 秒;P < 0.01)和认知(前:14.6 ± 3.5 秒;后:12.5 ± 1.6 秒;P < 0.05)TUG 表现均有改善。两种训练方案后,Berg 平衡量表均无明显变化:结论:两种训练都能改善静态和动态平衡,效果相似;但是,辅助跑步机训练似乎更有优势,因为患者往往感觉更安全。证据等级II,治疗研究--治疗结果调查。
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EFFECTS OF TREADMILL GAIT TRAINING ON BALANCE IN PARKINSON'S PATIENTS AFTER DEEP BRAIN STIMULATION.

Objective: After deep brain stimulation (DBS), patients with Parkinson's disease (PD) typically still present significant gait and postural stability problems, and thus additional interventions are needed. In this way, our purpose was evaluate the comparative effectiveness of treadmill training, with and without body weight support, on balance outcomes among patients with PD after DBS.

Methods: Eleven patients with PD that were using bilateral subthalamic nucleus DBS were evaluated using Time Up and Go test (TUG); Berg Balance Scale (BBS) and Static Posturography. In phase 1, all subjects participated in 8-weeks of treadmill training in conjunction with conventional physiotherapy. After six weeks (wash-out), each patient then participated in a subsequent 8-weeks of treadmill training with partial body weight support.

Results: After the phase 1, there were improvements on the cognitive TUG performance (Before: 15.7 ± 1,8 sec; After: 13.7 ± 3.1 sec; p < 0.01) and an increase of anteroposterior and medio-lateral body oscillation with eyes closed. After the phase 2, there were improvements in conventional (Before: 12.3 ± 2.0 sec; After: 10.7 ± 1.7 sec; p < 0.01) and cognitive (Before: 14.6 ± 3.5 sec; After: 12.5 ± 1.6 sec; p < 0.05) TUG performances. There were no significant changes in the Berg Balance Scale following either training protocol.

Conclusion: Both trainings improved static and dynamic balance and had similar results; however, supported treadmill training seemed to be a potentially superior option, as patients tended to feel safer. Level of Evidence II, therapeutic studies - investigation of treatment outcomes.

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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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