使用下肢主动-被动训练器骑自行车对神经系统疾病患者的影响:一项系统综述

Alison Barclay, S. Gray, L. Paul, Scott Rooney
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引用次数: 0

摘要

背景主动-被动训练器是神经系统残疾患者经常使用的一种安全、可行的锻炼方式。然而,有关其疗效的证据有限。本研究的目的是回顾研究有或没有功能性电刺激的下肢主动-被动教练自行车运动对神经系统疾病患者痉挛、心血管健康、功能和生活质量影响的文献。方法从开始到2021年6月,检索了五个电子数据库。研究包括:使用下肢主动-被动训练器作为自行车干预的随机对照试验;患有神经系统疾病的参与者,如多发性硬化症、脊髓损伤、中风和帕金森病;以及至少一种与痉挛、心血管健康、身体功能或生活质量有关的结果。结果共纳入12篇文章(423名参与者,52%为男性)。其中,6人使用功能性电刺激辅助主动-被动教练干预,其余6人仅使用主动-被动培训师干预。一项荟萃分析显示,步行耐力在统计学上有显著改善;然而,这只包括中风研究(6分钟步行测试表现,P<0.00001)。没有发现步行速度有统计学上的显著改善(P=0.31)。三项研究报告痉挛有显著改善(两项单独使用主动-被动训练器干预,一项使用带功能性电刺激的主动-被动教练)。一项研究报告了生活质量的改善。很少有研究考虑心血管健康。结论纳入的研究具有异质性设计、结果测量、运动处方和参与者残疾水平,这使得比较变得困难。主动-被动教练干预似乎可以提高中风患者的行走耐力;然而,对其他结果和其他情况的影响尚不清楚。功能性电刺激辅助骑行是否比主动-被动教练单独骑行更有益,目前仍不确定。
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The effects of cycling using lower limb active passive trainers in people with neurological conditions: a systematic review
Background Active passive trainers are frequently used as a safe, feasible way for people with neurological disabilities to exercise. However, evidence regarding their efficacy is limited. The aim of this study was to review the literature investigating the effects of lower limb active passive trainer cycling, with or without functional electrical stimulation, on spasticity, cardiovascular fitness, function and quality of life in people with neurological conditions Methods Five electronic databases were searched from inception to June 2021. Studies included: randomised controlled trials using lower limb active passive trainers as a cycling intervention; participants with neurological conditions, such as multiple sclerosis, spinal cord injury, stroke and Parkinson's disease; and at least one outcome related to spasticity, cardiovascular fitness, physical function or quality of life. Results A total of 12 articles were included (n=423 participants, 52% male). Of these, six used functional electrical stimulation-assisted active passive trainer interventions, and the remaining six used active passive trainer interventions alone. A meta-analysis demonstrated statistically significant improvement in walking endurance; however, this only included stroke studies (6-Minute Walk Test performance, P<0.00001). No statistically significant improvement in walking speed was found (P=0.31). A significant improvement in spasticity was reported by three studies (two using the active passive trainer intervention alone, one using the active passive trainer with functional electrical stimulation). One study reported improvement in quality of life. Few studies considered cardiovascular fitness. Conclusions The included studies featured heterogeneous designs, outcome measures, exercise prescriptions and participant disability levels, which made comparison difficult. Active passive trainer interventions appear to improve walking endurance in people with stroke; however, the effect on other outcomes and in other conditions remains unclear. It also remains uncertain as to whether functional electrical stimulation-assisted cycling is more beneficial than active passive trainer cycling alone.
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来源期刊
CiteScore
0.80
自引率
40.00%
发文量
56
期刊介绍: International Journal of Therapy and Rehabilitation (IJTR) publishes original research, providing a platform for the latest key research findings in therapy and rehabilitation. Review and analysis articles are invited internationally to enable the sharing of practices and developments worldwide, and to raise awareness of different cultural influences in health care. IJTR provides an interdisciplinary approach to therapy and rehabilitation by: -Providing a well-referenced source of information to all professionals involved in therapy and rehabilitation worldwide, including occupational therapists, physiotherapists, chiropodists and podiatrists, radiographers, speech and language therapists and orthoptists -Providing a peer-reviewed source of original research and information presented in an accessible, informative and professional medium -Providing a forum for the discussion of new ideas, information and issues relating to therapy and rehabilitation -Creating an awareness of the national and international issues affecting professionals involved in therapy and rehabilitation -Encouraging collaboration and sharing of new ideas between professions worldwide
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