可变优先级认知-运动双任务训练对老年脑卒中患者平衡功能的影响

关键词：脑卒中  双任务  可变优先级  平衡  跌倒

Keywords:stroke  dual-task training  variable priority training  balance  fall

摘要：

      摘要 目的：探讨可变优先级双任务训练较固定优先级双任务训练对老年脑卒中患者平衡功能的影响。 方法：40例老年脑卒中患者随机分为对照组（20例）和治疗组（20例）。两组均进行常规康复训练，对照组加用固定优先级双任务训练，治疗组加用可变优先级双任务训练，共4周。治疗前后应用Berg平衡量表（Berg balance scale， BBS）、姿势稳定性平衡测试、稳定极限测试、计时起立-行走测试（timed up and go test， TUGT）、双任务计时起立-行走测试（dual-task timed up and go test， DTUGT）、双任务成本（dual-task effect， DTE）、跌倒风险测试（fall risk test， FRT）评定两组平衡功能、双任务表现和预防跌倒能力。 结果：治疗前，两组各项评估指标组间比较，差异均无显著性意义（P>0.05）。治疗后，两组BBS、姿势稳定性平衡测试、稳定极限测试中的整体、向左、向右、向前左、向前右指标、TUGT、DTUGT、DTE、FRT得分均较治疗前有明显改善（P<0.05），且治疗组稳定极限测试中的向前指标较治疗前比较显著提高（P<0.05）；治疗组BBS，姿势稳定性平衡测试，稳定极限测试中的整体、向前指标，DTUGT、DTE、FRT得分改善程度均优于对照组（P<0.05）。 结论：可变优先级双任务训练较固定优先级双任务训练更有助于改善老年脑卒中患者平衡功能、双任务表现和预防跌倒能力。

Abstract:

      Abstract Objective： To explore the effect of variable priority dual-task training versus fixed priority dual-task training on balance function in elderly stroke patients. Method： Forty elderly stroke patients were randomly divided into control group (n=20) and treatment group (n=20). Both groups were trained in routine rehabilitation treatment. The control group received fixed priority dual-task training for 4 weeks， and the trial group received variable priority dual-task training for 4 weeks also. The Berg balance scale (BBS)， posture balance test， stability limit test， timed up and go test (TUGT)， dual-task timed up and go test (DTUGT)， dual-task effect (DTE)， and fall risk test (FRT) were used before and after treatment to assess two sets of balancing functions， dual-task performance， and fall prevention capabilities. Result： Before treatment， there was no significant difference between the two groups in various assessment indicators (P>0.05). After treatment， the scores of BBS， postural stability balance test， the stability limit test of overall， left， right， forward left， forward right， TUGT， DTUGT， DTE and FRT in the two groups were significantly improved compared with those before treatment (P<0.05)， and the forward indexes in the stability limit test in the treatment group were significantly increased compared with those before treatment (P<0.05). The improvement degree of BBS， postural stability balance test， the stability limit test of overall index， forward index， DTUGT， DTE and FRT scores in the treatment group was better than those in the control group (P<0.05). Conclusion： Variable priority dual-task training is more helpful to improve balance function， dual-task performance and fall prevention ability of elderly stroke patients than fixed priority dual-task training.