基于视觉反馈的平衡训练系统对脑卒中患者跌倒风险的应用研究

关键词：视觉反馈  平衡训练系统  脑卒中  跌倒风险  运动康复

Keywords:visual feedback  balance training system  stroke  fall risk  athletic rehabilitation

摘要：

      摘要 目的：分析基于视觉反馈的平衡训练系统对脑卒中患者跌倒风险的应用。 方法：选取2022年7月—2023年4月在南京明州康复医院住院的55例脑卒中患者为研究对象，使用数字量表法分为试验组（n=27）和对照组（n=28）。对照组进行常规平衡训练，试验组采用基于视觉反馈的平衡训练系统进行训练，4周后对比两组相关指标变化。使用计时起立步行测试（TUG）和10m行走测试（10-MWT）作为跌倒风险的筛选和评价指标，使用Berg平衡量表（BBS）评价平衡功能，使用功能性步行量表（FAC）评价步行功能，使用SINOFORCE全身肌力评定与训练系统检测膝关节屈曲、伸展肌群的峰力矩，使用Libra本体感觉平衡训练系统检测重心失控指数和双侧重心移动面积差值。 结果：两组干预后TUG时长均减少（P＜0.05），且试验组低于对照组（P＜0.05）；两组干预后10-MWT速度均提高（P＜0.05），且试验组高于对照组（P＜0.05）；两组干预后BBS得分均增高（P＜0.05），且试验组高于对照组（P＜0.05）；干预后试验组FAC分级提高（P＜0.05），对照组无明显变化（P＞0.05）；两组干预后屈膝、伸膝肌群峰力矩均提高（P＜0.05），两组间无显著性差异（P＞0.05）；干预后两组重心失控指数及双侧重心移动面积差值均降低（P＜0.05），且试验组低于对照组（P＜0.05）。 结论：基于视觉反馈的平衡训练系统在脑卒中患者跌倒风险的应用中效果显著，有助于改善患者的平衡功能、步行功能和下肢运动功能。

Abstract:

      Abstract Objective： To evaluate the application of visual feedback-based balance training system in reducing fall risk in stroke patients. Method： Fifty-five stroke patients admitted to Nanjing Mingzhou Rehabilitation Hospital from July 2022 to April 2023 were enrolled and randomly assigned to an experimental group （n=27） and a control group （n=28） according to the digital table method. The control group received routine balance training， while the experimental group received training using a visual feedback-based balance training system. After 4 weeks， the changes in relevant indicators between the two groups were compared. Time up and go test （TUG） and 10-meter walk test （10-MWT） were used as screening and evaluation indicators for fall risk. Berg balance scale （BBS） was used to evaluate the function of balance. Functional ambulation category scale （FAC） was used to evaluate the function of ambulation. Isokinetic muscle strength whole body muscle strength evaluating and training system SINOFORCE version was used to evaluate the peak torque of knee flexion and extension. Libra proprioceptive balance training system was used to evaluate the index reflecting center of gravity out of control， and calculate the difference in area of bilateral center of gravity movement. Result： After the intervention, the TUG duration decreased significantly in both groups（P＜0.05）， with the experimental group showing a greater reduction than the control group （P＜0.05）; the 10-MWT speed increased significantly in both groups （P＜0.05）， with the experimental group showing a significantly higher increase than the control group （P＜0.05）. The BBS scores improved in both groups （P＜0.05）， with the experimental group showing greater improvement than the control group （P＜0.05）. FAC improved significantly in the experimental group (P<0.05)， but showed no significant change in the control group (P>0.05); Peak torques of knee flexor and extensor muscles increased significantly in both groups（P＜0.05）， but there was no significant difference between the groups（P＞0.05）. Both groups demonstrated reductions in the center of pressure control index and bilateral center of pressure movement area differences （P＜0.05）， with the experimental group showing significantly lower than the control group （P＜0.05）. Conclusion： The visual feedback-based balance training system effectively reduces fall risk in stroke patients and significantly improves balance function, walking ability, and lower limb motor function.