双重任务训练对脑卒中后共济失调患者的平衡及步行能力的影响

目的：为了探索双重任务（DT）训练对脑卒中后共济失调患者的平衡及步行能力的影响。方法：40例脑卒中后共济失调患者随机分为DT组和单一任务（ST）组各20例，ST组接受常规运动训练，DT组在常规训练里的步行训练时接受DT训练。治疗前及治疗4周后对2组患者进行以下评定：单一任务模式的计时起立-走测试（TUG-S）、运动双重任务的计时起立-走测试（TUG-M）、认知双重任务的计时起立-走测试（TUG-C）、共济失调等级评定量表（SARA）、Berg 平衡量表（BBS）及改良Barthel指数（MBI）。结果：治疗4周后，2组的TUG-S、TUG-M、TUG-C时间及SARA评分较治疗前均明显降低（均P＜0.05），BBS和MBI评分较治疗前均明显升高（均P＜0.05）；与ST组相比，DT组的TUG-S、TUG-M、TUG-C时间及SARA评分治疗前后的差值均降低更明显（均P＜0.05），BBS和MBI评分治疗前后的差值均升高更显著（均P＜0.05）。结论：双重任务训练可提高脑卒中后共济失调患者的平衡及步行能力，有助于其参与日常生活活动。

Effects of dual task training on balance and walking ability in patients with ataxia after stroke

Objective: To explore the effects of dual task (DT) training on balance and walking ability in patients with ataxia after stroke. Methods: Totally, 40 patients with post-stroke ataxia were randomly divided into DT group and single task (ST) group with 20 cases each. ST group received routine exercise training, while DT group received DT training during walking training on the basis of routine training. Before and after 4 weeks of treatment, two groups of patients were evaluated as follows: Time Up and Go Test-Single (TUG-S), Time Up and Go Test-Motor (TUG-M), Time Up and Go Test-Cognitive (TUG-C), Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS) and modified Barthel index (MBI). Results: After 4 weeks of treatment, the time of TUG-S, TUG-M, TUG-C and SARA scores in the two groups decreased significantly (all P < 0.05), while BBS and MBI scores increased significantly (all P<0.05). Compared with ST group, the difference of TUG-S, TUG-M, TUG-C time and SARA score in DT group decreased significantly after treatment (all P<0.05), while BBS and MBI scores increased significantly (all P<0.05). Conclusion: Dual task training can improve the balance and walking ability of patients with ataxia after stroke, and help them to participate in daily living activities.