目的:系统评价针刺结合康复训练治疗脑卒中后平衡功能障碍的有效性,为临床提供依据。方法:全面检索PubMed、Embase、Cochrane(Central)、Web of Science、中国知网(CNKI)、万方数据库(WF)、维普(VIP)及中国生物医学数据库(CBM)中相关研...目的:系统评价针刺结合康复训练治疗脑卒中后平衡功能障碍的有效性,为临床提供依据。方法:全面检索PubMed、Embase、Cochrane(Central)、Web of Science、中国知网(CNKI)、万方数据库(WF)、维普(VIP)及中国生物医学数据库(CBM)中相关研究,纳入分析针刺结合康复训练对比单纯康复训练治疗脑卒中后平衡功能障碍的随机对照试验。由两位评审员独立进行文献检索、研究筛选、数据提取及质量评估。本研究采用Cochrane风险评估工具以评估纳入研究的质量,并使用Review Manager 5.3和Stata 12.0进行统计分析。结果:共纳入随机对照研究15个,涉及总人数1122例。结果发现治疗结束后两组在Berg平衡功能评分、Fugl-Meyer平衡功能评分、Fugl-Meyer下肢运动功能评分、步行10 m时间及改良Barthel指数评分上的差异均有统计学意义,且针刺结合康复组疗效优于单纯康复组,WMD分别为5.63(95%CI:4.32~6.94,P<0.00001)、1.09(95%CI:0.58~1.60,P<0.00001)、2.71(95%CI:0.88~4.54,P=0.004)、-13.29(95%CI:-23.30^-3.28,P=0.009)、7.21(95%CI:2.27~12.15,P=0.004)。结论:针刺结合康复训练对比单纯康复训练在改善脑卒中后平衡功能障碍方面更有优势,差异有统计学意义。展开更多
Multiple sclerosis (MS) is a chronic inflammatory disorder of central nervous system (CNS), characterized by the presence of multifocal demyelination plaques with characteristic symptoms as fatigue, balance disorder, ...Multiple sclerosis (MS) is a chronic inflammatory disorder of central nervous system (CNS), characterized by the presence of multifocal demyelination plaques with characteristic symptoms as fatigue, balance disorder, reduced endurance in gait and decrease in quality of life. The study supposed that the motor treatment through dance could represent useful therapeutic option, together with other treatments already in use such as the pharmacological and physiotherapy one. We included 9 person (6 male and 3 female) affected by relapsing-remitting multiple sclerosis (RRMS) with an expanded disability status scale (EDSS) score less than 3, underwent rehabilitation treatment with Argentine Tango (Riabilitango®method). The study lasted twenty months, considering a sixty-minute session a week. The aim of the study was to verify the real improvement of quality of life, fatigue, balance disorder and gait endurance due to the dance treatment. We collected outcomes data of Short Form 36 (SF-36) in physical function (PF) (45.56 ± 21.42 vs. 69.44 ± 23.64), vitality (VT) (45.00 ± 7.90 vs. 67.77 ± 6.18), social function (SF) (54.00 ± 13.86 vs. 75.11 ± 6.25), general health (GH) (32.22 ± 5.06 vs. 54.11 ± 5.20);Modified fatigue impact test scales (MFSI) (3.56 ± 3.72 vs. 37.22 ± 3.88);Berg balance scale (BBS-it) (33.89 ± 4.12 vs. 45.11 ± 3.51);Six Minute Walk Test (6mWT), in distance (m) (352.89 ± 174.56 vs. 397.22 ± 174.83), oxygen saturation in arterial blood (%SpO2) (87.67 ± 3.35 vs. 91.78 ± 5.92) and beast per minute (bpm) (82.67 ± 13.08 vs. 72.67 ± 10.52). We found statistically significant (p In conclusion, despite the small sample size included, the results confirm that Riabilitango®significantly leads to better functional performances in person affected by RRMS with EDSS less then 3, finding benefits in terms of quality of life. Data suggest that integration between dance treatment method and the pharmacological, could represent the useful approach.展开更多
Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary con...Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross- sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.展开更多
The study evaluated the use of the Mini-Mental State Examination scale (MMSE), Tinettiscale, and Motor Scale for the Elderly (EMTI) toassist in the diagnosis of potential needs observed in elderlies with Mild Cognitiv...The study evaluated the use of the Mini-Mental State Examination scale (MMSE), Tinettiscale, and Motor Scale for the Elderly (EMTI) toassist in the diagnosis of potential needs observed in elderlies with Mild Cognitive Impairment. This was aquasi-experimental research, conducted in a Basic Health Unit in thecityof Rio de Janeiro in 2014. The sample population consisted of 22 elderlies aged 64 to 88 years and 86.36% females. The SAS statistical software (version 9.3.1) and Kruskal-Wallis test were used at a 95% confidence interval and a significance level of 0.05 and demonstrated significant differences in the evaluations performed before and after the intervention. The detected diagnoses were: impaired memory, the risk of falls, and willingness to improved relationships, among others. The evaluations showed MMSE results that were suggestive of cognitive impairment in 22.73% of the elderlies;the Tinetti scale showed a high risk of falls in 31.82% of theelderlies;and EMTI with 88.36 points, which was equivalent to the normal low classification. The intervention took place through ten weekly activity sessions after the initial evaluations. In the second evaluation, the Tinetti showed 59.09% of the elderlies with a moderate risk of falls and the EMTI as the normal average classification with 90.32 points. It was concluded that the scales offered diagnostic possibilities, which allowed for the implementation of necessary interventions according to the detected problems.展开更多
This study analyzed postural balance in the elderly with mild cognitive impairment and its relationship to accidental falls. A quantitative and quasi-experimental method was used in a sample of 43 elderlies between 64...This study analyzed postural balance in the elderly with mild cognitive impairment and its relationship to accidental falls. A quantitative and quasi-experimental method was used in a sample of 43 elderlies between 64 and 88 years old, mostly females. Data collection was performed in two Basic Health Units in the city of Rio de Janeiro in 2014. The instruments used were the Mini-Mental State Examination (MMSE), Tinetti scale, Motor Scale for the Elderly (EMTI) scale, and Elderly Falls Diary. The data were analyzed with the SAS statistical software version 9.3.1. The scales were applied before and after the psychomotor interventions. A significant difference was observed between the evaluating moments. Balance improvements were observed in all age groups, suggesting that all elderlies, regardless of age, showed satisfactory responses to the implemented psychomotor activities. The elderlies who fell more frequently were those between 60 and 69 years old. It is noteworthy that the age group with the lowest incidence of falls was that of elderlies between 70 and 79 years old. It was concluded that psychomotor activities are beneficial, regardless of age, proving their effectiveness when continued stimuli with cognitive and psychomotor activities are carried out.展开更多
文摘Multiple sclerosis (MS) is a chronic inflammatory disorder of central nervous system (CNS), characterized by the presence of multifocal demyelination plaques with characteristic symptoms as fatigue, balance disorder, reduced endurance in gait and decrease in quality of life. The study supposed that the motor treatment through dance could represent useful therapeutic option, together with other treatments already in use such as the pharmacological and physiotherapy one. We included 9 person (6 male and 3 female) affected by relapsing-remitting multiple sclerosis (RRMS) with an expanded disability status scale (EDSS) score less than 3, underwent rehabilitation treatment with Argentine Tango (Riabilitango®method). The study lasted twenty months, considering a sixty-minute session a week. The aim of the study was to verify the real improvement of quality of life, fatigue, balance disorder and gait endurance due to the dance treatment. We collected outcomes data of Short Form 36 (SF-36) in physical function (PF) (45.56 ± 21.42 vs. 69.44 ± 23.64), vitality (VT) (45.00 ± 7.90 vs. 67.77 ± 6.18), social function (SF) (54.00 ± 13.86 vs. 75.11 ± 6.25), general health (GH) (32.22 ± 5.06 vs. 54.11 ± 5.20);Modified fatigue impact test scales (MFSI) (3.56 ± 3.72 vs. 37.22 ± 3.88);Berg balance scale (BBS-it) (33.89 ± 4.12 vs. 45.11 ± 3.51);Six Minute Walk Test (6mWT), in distance (m) (352.89 ± 174.56 vs. 397.22 ± 174.83), oxygen saturation in arterial blood (%SpO2) (87.67 ± 3.35 vs. 91.78 ± 5.92) and beast per minute (bpm) (82.67 ± 13.08 vs. 72.67 ± 10.52). We found statistically significant (p In conclusion, despite the small sample size included, the results confirm that Riabilitango®significantly leads to better functional performances in person affected by RRMS with EDSS less then 3, finding benefits in terms of quality of life. Data suggest that integration between dance treatment method and the pharmacological, could represent the useful approach.
文摘Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross- sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.
文摘The study evaluated the use of the Mini-Mental State Examination scale (MMSE), Tinettiscale, and Motor Scale for the Elderly (EMTI) toassist in the diagnosis of potential needs observed in elderlies with Mild Cognitive Impairment. This was aquasi-experimental research, conducted in a Basic Health Unit in thecityof Rio de Janeiro in 2014. The sample population consisted of 22 elderlies aged 64 to 88 years and 86.36% females. The SAS statistical software (version 9.3.1) and Kruskal-Wallis test were used at a 95% confidence interval and a significance level of 0.05 and demonstrated significant differences in the evaluations performed before and after the intervention. The detected diagnoses were: impaired memory, the risk of falls, and willingness to improved relationships, among others. The evaluations showed MMSE results that were suggestive of cognitive impairment in 22.73% of the elderlies;the Tinetti scale showed a high risk of falls in 31.82% of theelderlies;and EMTI with 88.36 points, which was equivalent to the normal low classification. The intervention took place through ten weekly activity sessions after the initial evaluations. In the second evaluation, the Tinetti showed 59.09% of the elderlies with a moderate risk of falls and the EMTI as the normal average classification with 90.32 points. It was concluded that the scales offered diagnostic possibilities, which allowed for the implementation of necessary interventions according to the detected problems.
文摘This study analyzed postural balance in the elderly with mild cognitive impairment and its relationship to accidental falls. A quantitative and quasi-experimental method was used in a sample of 43 elderlies between 64 and 88 years old, mostly females. Data collection was performed in two Basic Health Units in the city of Rio de Janeiro in 2014. The instruments used were the Mini-Mental State Examination (MMSE), Tinetti scale, Motor Scale for the Elderly (EMTI) scale, and Elderly Falls Diary. The data were analyzed with the SAS statistical software version 9.3.1. The scales were applied before and after the psychomotor interventions. A significant difference was observed between the evaluating moments. Balance improvements were observed in all age groups, suggesting that all elderlies, regardless of age, showed satisfactory responses to the implemented psychomotor activities. The elderlies who fell more frequently were those between 60 and 69 years old. It is noteworthy that the age group with the lowest incidence of falls was that of elderlies between 70 and 79 years old. It was concluded that psychomotor activities are beneficial, regardless of age, proving their effectiveness when continued stimuli with cognitive and psychomotor activities are carried out.
