The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patients’ dynamic balance ability

[Purpose] This study aims to examine stroke patients’ changes in dynamic balance ability through stair gait training where in proprioceptive neuromuscular facilitation (PNF) was applied. [Subjects and Methods] In total 30 stroke patients participated in this experiment and were randomly and equally allocated to an experimental group and a control group. The experimental group received exercise treatment for 30 min and stair gait training where in PNF was applied for 30 min and the control group received exercise treatment for 30 min and ground gait training where in PNF was applied for 30 min. For the four weeks of the experiment, each group received training three times per week, for 30 min each time. Berg Balance Scale (BBS) values were measured and a time up and go (TUG) test and a functional reach test (FRT) were performed for a comparison before and after the experiment. [Results] According to the result of the stroke patients’ balance performance through stair gait training, the BBS and FRT results significantly increased and the TUG test result significantly decreased in the experimental group. On the contrary, BBS and FRT results did not significantly increase and the TUG test result did not significantly decrease in the control group. According to the result of comparing differences between before and after training in each group, there was a significant change in the BBS result of the experimental group only. [Conclusions] In conclusion, the gait training group to which PNF was applied saw improvements in their balance ability, and a good result is expected when neurological disease patients receive stair gait training applying PNF.Key words: Proprioceptive neuromuscular facilitation, Stroke, Balance ability     

Effect of space balance 3D training using visual feedback on balance and mobility in acute stroke patients

[Purpose] The purpose of the study was to determine the effects of balance training with Space Balance 3D, which is a computerized measurement and visual feedback balance assessment system, on balance and mobility in acute stroke patients. [Subjects and Methods] This was a randomized controlled trial in which 52 subjects were assigned randomly into either an experimental group or a control group. The experimental group, which contained 26 subjects, received balance training with a Space Balance 3D exercise program and conventional physical therapy interventions 5 times per week during 3 weeks. Outcome measures were examined before and after the 3-week interventions using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Postural Assessment Scale for Stroke Patients (PASS). The data were analyzed by a two-way repeated measures ANOVA using SPSS 19.0. [Results] The results revealed a nonsignificant interaction effect between group and time period for both groups before and after the interventions in the BBS score, TUG score, and PASS score. In addition, the experimental group showed more improvement than the control group in the BBS, TUG and PASS scores, but the differences were not significant. In the comparisons within the groups by time, both groups showed significant improvement in BBS, TUG, and PASS scores. [Conclusion] The Space Balance 3D training with conventional physical therapy intervention is recommended for improvement of balance and mobility in acute stroke patients.Key words: Balance training, Visual feedback, Acute stroke patients     

The Effects of Additional Action Observational Training for Functional Electrical Stimulation Treatment on Weight Bearing,Stability and Gait Velocity of Hemiplegic Patients

[Purpose] The purpose of this study was to evaluate the functional effects of additional action observational training for functional electrical stimulation treatment on weight bearing, stability and gait velocity of hemiplegic patients. [Subjects and Methods] Twenty subjects were randomized into two groups. Subjects more than six months post-stroke participated. Balance and gait velocity were measured at the baseline, and after six weeks of treatment. Both groups received functional electrical stimulation treatment. The experimental group additionally received action observational training. The paired t-test was used to analyze differences in the outcome measures between before and after the intervention. The difference between the groups was compared using the independent t-test. [Results] The experimental group showed significant increases in weight bearing (anterior·posterior, right·left) on the affected side, stability index and gait velocity. The control group showed only a significant increase in anterior·posterior weight bearing on the affected side. Moreover, according to the comparison of training effects between in the two groups, the variables of anterior·posterior weight bearing, stability index and gait velocity revealed a statistically significant difference. [Conclusion] Additional action observational training for functional electrical stimulation treatment should be considered as a therapeutic method in physical therapy for the improvement of weight bearing, stability index and gait velocity of hemiplegic patients.Key words: Action observational training, Functional electrical stimulation, Hemiplegia     

The effects of ramp gait exercise with PNF on stroke patients’ dynamic balance

[Purpose] This study examined the effects of ramp gait training using lower extremity patterns of proprioceptive neuromuscular facilitation (PNF) on chronic stroke patients’ dynamic balance ability. [Subjects and Methods] In total, 30 stroke patients participated in this study, and they were assigned randomly and equally to an experimental group and a control group. The experimental group received exercise treatment for 30 min and ramp gait training with PNF for 30 min. The control group received exercise treatment for 30 min and ground gait training for 30 min. The interventions were conducted in 30 min sessions, three times per week for four week. The subjects were assessed with the Berg balance scale test, timed up and go test, and functional reach test before and after the experiment and the results were compared. [Results] After the intervention, the BBS and FRT values had significantly increased and the TUG value had significantly decreased in the experimental group; however, the BBS, FRT, and TUG values showed no significant differences in the control group. In addition, differences between the two groups before the intervention and after the intervention were not significant. [Conclusion] In conclusion, ramp gait training with PNF improved stroke patients’ dynamic balance ability, and a good outcome of ramp gait training with PNF is also expected for other neurological system disease patients.Key words: Stroke, Proprioception, Ramp gait     

Effects of gait training with horizontal impeding force on gait and balance of stroke patients

[Purpose] The purpose of this study was to investigate the effects of treadmill training with a horizontal impeding force applied to the center of upper body mass on the gait and balance of post-stroke patients. [Subjects and Methods] Twenty-four subjects with hemiplegia less than 3 months after stroke onset were randomly assigned to 2 groups: an applied horizontal impeding force on treadmill training (experimental) group (n = 12), and a control group (n = 12). Both groups walked on a treadmill at a comfortable or moderate speed for 20 minutes per day, 3 sessions per week for 8 weeks after a pre-test. The experimental group also had a horizontal impeding force applied to the center of their upper body mass. [Results] All groups demonstrated significant improvement after 8 weeks compared to baseline measurements. In intra-group comparisons, the subjects’ gait ability (CGS, MGS, cadence, and step length) and balance ability (TUG, BBS, and FRT) significantly improved. In inter-group comparisons, the experimental group’s improvement was significantly better in CGS MGS, cadence, step length, TUG, and BBS, but not in FRT. [Conclusion] Treadmill training was identified as an effective training method that improved gait and balance ability. A horizontal impeding force applied during treadmill training was more effective than treadmill walking training alone at improving the gait and dynamic balance of patients with stroke.Key words: Treadmill gait, Horizontal impeding force, Upper body     

Effects of robot-assisted gait training on the balance and gait of chronic stroke patients: focus on dependent ambulators

[Purpose] The purpose of this study was to confirm the effect of robot-assisted gait training on the balance and gait ability of stroke patients who were dependent ambulators. [Subjects and Methods] Twenty stroke patients participated in this study. The participants were allocated to either group 1, which received robot-assisted gait training for 4 weeks followed by conventional physical therapy for 4 weeks, or group 2, which received the same treatments in the reverse order. Robot-assisted gait training was conducted for 30 min, 3 times a week for 4 weeks. The Berg Balance Scale, Modified Functional Reach Test, Functional Ambulation Category, Modified Ashworth Scale, Fugl-Meyer Assessment, Motricity Index, and Modified Barthel Index were assessed before and after treatment. To confirm the characteristics of patients who showed a significant increase in Berg Balance Scale after robot-assisted gait training as compared with physical therapy, subgroup analysis was conducted. [Results] Only lateral reaching and the Functional Ambulation Category were significantly increased following robot-assisted gait training. Subscale analyses identified 3 patient subgroups that responded well to robot-assisted gait training: a subgroup with hemiplegia, a subgroup in which the guidance force needed to be decreased to needed to be decreased to ≤45%, and a subgroup in which weight bearing was decreased to ≤21%. [Conclusion] The present study showed that robot-assisted gait training is not only effective in improving balance and gait performance but also improves trunk balance and motor skills required by high-severity stroke patients to perform activities daily living. Moreover, subscale analyses identified subgroups that responded well to robot-assisted gait training.Key words: Stroke, Robotics, Gait     

渐进性下蹲式抗阻训练对帕金森病患者运动功能的改善效果

目的 观察渐进性下蹲式抗阻训练对帕金森病（Parkinson disease, PD）患者运动功能的改善效果。方法 将纳入的帕金森病患者随机分为对照组与试验组。对照组采用常规康复训练方法，包括力量训练、平衡功能训练和步态训练；试验组在此基础上增加渐进性下蹲式抗阻训练。两组分别在治疗前及治疗后4周评估Berg平衡量表（Berg balance scale,BBS）评分、起立-行走计时测验（time up and go test,TUG）结果、Fugl-Meyer运动功能评分量表（Fugl-Meyer assessment,FMA）评分及总有效率。结果 最终纳入40例患者，每组20例。治疗后两组BBS评分、TUG计时、FMA评分均较治疗前改善（P<0.001），且试验组3项的改善率均优于对照组（P<0.05）；试验组患者总有效率高于对照组（95.0%vs85.0%,P<0.05）。结论 渐进性下蹲式抗阻训练可进一步改善接受常规康复训练患者的平衡能力，并提高其运动功能。     

Influence of Resistance Exercise Training to Strengthen Muscles across Multiple Joints of the Lower Limbs on Dynamic Balance Functions of Stroke Patients

[Purpose] The objective of this study was to evaluate the effects of resistance exercise training for strengthening muscles across multiple joints on the dynamic balance function of stroke patients. [Subjects and Methods] Subjects in the training group (n=14) and the control group (n=14) received conservative physical therapy for 30 minutes per day, five days per week, for a period of six weeks. The training group additionally performed three sets (eight to 10 repetitions per set) of resistance exercise at 70% of the 1-repetition maximum (1RM) to strengthen muscles across multiple joints. The control group did the same exercises for the same duration but without resistance. To assess dynamic balance function, before and after the intervention, we measured antero-posterior (A-P) and medio-lateral (M-L) sway distances, the Berg balance scale (BBS), and the timed up and go (TUG) times. [Results] Compared to pre-intervention values, the BBS score showed significant increases in both groups, and A-P and M-L sway distances and TUG times showed significant decreases in both groups. Changes in A-P and M-L sway distances, BBS scores, and TUG times were significantly different between the muscle training group and the control group. [Conclusion] Training involving muscle strength across multiple joints is an effective intervention for improvement of dynamic balance function of stroke patients.Key words: Muscle strength exercise, Dynamic balance, Stroke     

The effects of patient-centered task-oriented training on balance activities of daily living and self-efficacy following stroke

[Purpose] This study aimed to determine whether a task-oriented training program improved balance, activities of daily living (ADL) performance, and self-efficacy in stroke patients. Twenty patients with stroke were recruited from a hospital in Cheongju, Korea. [Subjects] Ten of the subjects were assigned to an experimental group that participated in the task-oriented training program, and the other 10 were assigned to a control group that received traditional rehabilitation therapy. [Methods] In the two groups, balance was measured with the Berg Balance Scale (BBS), ADL performance with the Modified Barthel Index (MBI), and self-efficacy with the Self-Efficacy Scale (SES), before and after 4 weeks of training. [Results] Comparative analysis of the experimental group’s pretest and post-test results showed statistically significant differences in the BBS, MBI, and SES scores. There were also significant between-group differences in the BBS, MBI, and SES scores. [Conclusion] The results suggest that a task-oriented training program can be an effective intervention to improve balance ability, ADL performance, and self-efficacy in stroke patients.Key words: Stroke, Task-oriented training, Self-efficacy     

视觉反馈平衡训练对脑卒中偏瘫患者平衡及功能性转移能力的影响

目的:观察脑卒中偏瘫患者通过视觉反馈平衡训练治疗对平衡及功能性转移能力的作用。方法:脑卒中偏瘫患者32例,分为运动组17例和对照组15例,均接受常规康复治疗。运动组加视觉反馈平衡训练。2组治疗前后分别采用Berg平衡评定量表(BBS)和"站立-走"计时测试(TUG)评定。结果:治疗5周后,BBS评分2组与治疗前比较均明显提高;TUG计时明显缩短;运动组2项评定的改善程度均明显优于对照组(均P0.05)。结论:脑卒中偏瘫患者配合视觉反馈平衡训练能明显提高平衡及功能性转移的能力,增加站立和行走的安全性。     

Effects of brain-computer interface-based functional electrical stimulation on balance and gait function in patients with stroke: preliminary results

[Purpose] The purpose of this study was to determine the effects of brain-computer interface (BCI)-based functional electrical stimulation (FES) on balance and gait function in patients with stroke. [Subjects] Subjects were randomly allocated to a BCI-FES group (n=5) and a FES group (n=5). [Methods] The BCI-FES group received ankle dorsiflexion training with FES according to a BCI-based program for 30 minutes per day for 5 days. The FES group received ankle dorsiflexion training with FES for the same duration. [Results] Following the intervention, the BCI-FES group showed significant differences in Timed Up and Go test value, cadence, and step length on the affected side. The FES group showed no significant differences after the intervention. However, there were no significant differences between the 2 groups after the intervention. [Conclusion] The results of this study suggest that BCI-based FES training is a more effective exercise for balance and gait function than FES training alone in patients with stroke.Key words: Brain-computer interface, Functional electrical stimulation, Gait     

Treadmill Sideways Gait Training with Visual Blocking for Patients with Brain Lesions

[Purpose] The aim of this study was to verify the effect of sideways treadmill training with and without visual blocking on the balance and gait function of patients with brain lesions. [Subjects] Twenty-four stroke and traumatic brain injury subjects participated in this study. They were divided into two groups: an experimental group (12 subjects) and a control group (12 subjects). [Methods] Each group executed a treadmill training session for 20 minutes, three times a week, for 6 weeks. The sideways gait training on the treadmill was performed with visual blocking by the experimental group and with normal vision by the control group. A Biodex Gait Trainer 2 was used to assess the gait function. It was used to measure walking speed, walking distance, step length, and stance time on each foot. The Five-Times-Sit-To-Stand test (FTSST) and Timed Up and Go test (TUG) were used as balance measures. [Results] The sideways gait training with visual blocking group showed significantly improved walking speed, walking distance, step length, and stance time on each foot after training; FTSST and TUG times also significantly improved after training in the experimental group. Compared to the control group, the experimental group showed significant increases in stance time on each foot. [Conclusion] Sideways gait training on a treadmill with visual blocking performed by patients with brain lesions significantly improved their balance and gait function.Key words: Brain lesions, Treadmill training, Visual block     

The Effect of Mirror Therapy Integrating Functional Electrical Stimulation on the Gait of Stroke Patients

[Purpose] The aim of the present study was to examine whether mirror therapy in conjunction with FES in stroke patients can improve gait ability. [Subjects] This study was conducted with 30 subjects who were diagnosed with hemiparesis due to stroke. [Methods] Experimental group I contained 10 subjects who received mirror therapy in conjunction with functional electrical stimulation, experimental group II contained 10 subjects who received mirror therapy, and the control group contained 10 subjects who received a sham therapy. A gait analysis was performed using a three-dimensional motion capture system, which was a real-time tracking device that delivers data in an infrared mode via reflective markers using six cameras. [Results] The results showed a significant difference in gait velocity between groups after the experiment, and post hoc analysis revealed significant differences between experimental group I and the control group and between experimental group II and the control group, respectively. There were also significant differences in step length and stride length between the groups after the experiment, and post hoc analysis revealed significant differences between experimental group I and control group. [Conclusion] The present study showed that mirror therapy in conjunction with FES is more effective for improving gait ability than mirror therapy alone.Key words: Mirror therapy, Functional electrical stimulation, Gait analysis     

末端驱动型下肢机器人对脑卒中患者步态的影响

目的 探讨末端驱动型下肢康复机器人训练对脑卒中患者下肢步行能力、下肢运动功能、步态及平衡功能的影响。 方法 将2018年8月至2019年8月在空军军医大学第一附属医院住院治疗的、符合纳入标准的39例脑卒中患者,按照随机数字表法将其分为训练组(21例)和对照组(18例)。2组患者均接受常规康复治疗,包括偏瘫肢体综合训练、中频脉冲电刺激等,对照组在此基础上接受减重平板步行训练,训练组接受末端驱动的下肢康复机器人训练,每日1次、每次20 min、每周6 d、持续4周。治疗前,治疗4周后（治疗后）,采用功能性步行分级(FAC)、Fugl-Meyer运动功能评分下肢部分(FMA-LE)、威斯康星步态量表(WGS)及Berg平衡量表(BBS)进行评定。 结果 治疗前,2组患者FAC、FMA-LE、WGS及BBS评分比较,差异无统计学意义(P>0.05)。治疗后,2组患者各项指标均较组内治疗前显著改善(P<0.05),且训练组治疗后FAC分级［(2.61±0.70)级］、WGS［(23.29±3.85)分］及BBS评分［(35.40±8.41)分］较对照组显著提高(P<0.05)。 结论 末端驱动型下肢康复机器人训练较传统康复治疗,能更好地改善脑卒中患者的步行能力、步态及平衡功能。     

The influence of horseback riding training on the physical function and psychological problems of stroke patients

[Purpose] The purpose of this study was to determine the influence of horseback riding training on the physical function and psychological problems of stroke patients. [Subjects and Methods] Thirty stroke patients were divided evenly into an experimental group and a control group. Both groups carried out neurodevelopmental treatment. The experimental group additionally performed mechanical horseback riding training for 30 minutes a day, 5 days a week, for 6 weeks. Physical function was evaluated using the Berg Balance Scale (BBS) and the Timed Up and Go Test (TUGT). Psychological problems were assessed using the Beck Depression Inventory (BDI). In order to compare differences within groups between before and after the experiment, the paired t test was conducted. In order to compare differences between groups before and after the experiment, the independent t test was conducted. [Results] In the experimental group, the BBS, TUGT, and BDI showed significant improvements after the intervention. The experimental group’s BBS, TUGT, and BDI post-intervention changes were significantly better than those observed in the control group. [Conclusion] According to our results, horseback riding training has a positive effect on the physical function and psychological problems of stroke patients.Key words: Horseback riding training, Physical function, Psychological problems     

The Effects of Isokinetic Eccentric Resistance Exercise for the Hip Joint on Functional Gait of Stroke Patients

[Purpose] The purpose of this study was to determine the effects of resistance exercise strengthening the hip flexor and extensor muscles on functional gait of stroke patients. [Subjects and Methods] Twenty patients were randomized into two groups. Both groups performed conventional physical therapy for six weeks. The experimental group also performed isokinetic eccentric resistance exercises for the hip flexor and extensor muscles. The hip muscle strength, stair up and down time, TUG time(timed up and go test), and 10 m gait velocity were measured at the baseline, and after 3 weeks, and 6 weeks of treatment. [Results] The experimental showed significant improvements compared to the baseline in hip muscle strength, stair up and down time, TUG time and 10 m gait velocity after 3 and 6 weeks of treatment. After 3 and 6 weeks of treatment, there were gains in hip muscle strength and 10 m gait velocity. The control group showed no significant increase in hip muscle strength, stair up and down time, TUG time or 10 m gait velocity. [Conclusion] We consider that conventional physical therapy contributes to the improvement of functional gait of stroke patients. However, it is more desirable to perform isokinetic eccentric resistance exercises for hip flexor and extensor muscles combined with conventional physical therapy for the improvement of hip muscle strength, stair up and down time, TUG time and 10 m gait velocity.Key words: Functional gait, Isokinetic exercise, Stroke patients     

肉毒毒素注射后功能性电刺激与运动平板同步治疗脑卒中后足下垂及足内翻的疗效观察

目的观察A型肉毒毒素(BTX-A)注射后功能性电刺激同步减重平板治疗对脑卒中患者足下垂及足内翻的影响。 方法采用随机数字表法将67例脑卒中后出现足下垂及内翻的患者分为联合治疗组（22例）、电刺激组（23例）及常规治疗组（22例）。3组患者均在B超及电刺激引导下进行BTX-A注射治疗,24h后常规治疗组患者给予常规干预（包括使用脑保护剂及进行肢体功能锻炼、步态训练、平衡训练、日常生活活动能力训练等）,联合治疗组在常规治疗基础上辅以功能性电刺激与减重平板同步治疗,电刺激组则在常规治疗基础上辅以功能性电刺激。于治疗前、治疗6周后对各组患者进行疗效评定,具体疗效评定指标包括胫骨前肌与腓肠肌外侧头积分肌电值（iEMG）、踝背伸协同收缩率(CR)、改良Ashworth量表(MAS)评分、Berg平衡量表(BBS)评分、功能性步行分级(FAC)、踝背伸与外翻活动度(ROM)等。 结果治疗后3组患者胫骨前肌iEMG、腓肠肌外侧头iEMG、踝背伸CR、MAS评分、BBS评分、FAC评分、踝背伸与外翻ROM均较治疗前明显改善（P<0.05）;通过组间比较发现,治疗后3组患者腓肠肌外侧头iEMG组间差异无统计学意义(P>0.05);联合治疗组胫骨前肌iEMG［(1.54±0.23)mV］、踝背伸CR［(13.32±8.47)%］、MAS评分［(0.29±0.35)分］、BBS评分［(42.37±4.28)分］、FAC评分［(4.26±1.14)分］、踝背伸ROM［(15.58±1.32)°］与外翻ROM［(14.33±1.41)°］均显著优于电刺激组及常规治疗组水平(P<0.05)。 结论于BTX-A注射后同步进行功能性电刺激及减重平板训练,能进一步改善脑卒中患者足下垂及足内翻畸形,促其步行功能改善,该联合疗法值得临床推广、应用。     

Effects of a multichannel dynamic functional electrical stimulation system on hemiplegic gait and muscle forces

[Purpose] The purpose of the study was to design and implement a multichannel dynamic functional electrical stimulation system and investigate acute effects of functional electrical stimulation of the tibialis anterior and rectus femoris on ankle and knee sagittal-plane kinematics and related muscle forces of hemiplegic gait. [Subjects and Methods] A multichannel dynamic electrical stimulation system was developed with 8-channel low frequency current generators. Eight male hemiplegic patients were trained for 4 weeks with electric stimulation of the tibia anterior and rectus femoris muscles during walking, which was coupled with active contraction. Kinematic data were collected, and muscle forces of the tibialis anterior and rectus femoris of the affected limbs were analyzed using a musculoskelatal modeling approach before and after training. A paired sample t-test was used to detect the differences between before and after training. [Results] The step length of the affected limb significantly increased after the stimulation was applied. The maximum dorsiflexion angle and maximum knee flexion angle of the affected limb were both increased significantly during stimulation. The maximum muscle forces of both the tibia anterior and rectus femoris increased significantly during stimulation compared with before functional electrical stimulation was applied. [Conclusion] This study established a functional electrical stimulation strategy based on hemiplegic gait analysis and musculoskeletal modeling. The multichannel functional electrical stimulation system successfully corrected foot drop and altered circumduction hemiplegic gait pattern.Key words: Hemiplegia, Functional electrical stimulation, Gait     

Effects of trunk rotation induced treadmill gait training on gait of stroke patients: a randomized controlled trial

[Purpose] This study was conducted to find out the effect of arm swing during treadmill training on the gait of stroke patients. [Subjects and Methods] This study subjects were 20 stroke subjects patients who were randomly assigned to either the experimental group (EG) or the control group (CG), 10 subjects in each group. Therapists induced arm swing of affected side of EG subjects using Nordic poles, while subjects in CG had the affected arm restricted to prevent arm swing. Training was performed for 30 minutes, 3 times a week for 4 weeks. The timed up and go test (TUG), the dynamic gait index (DGI) and the 6-minute walk test (6MWT) were assessed before and after the training. [Results] After the training, there were no significant differences in the TUG times of EG and CG. There were significant differences in the DGI and the 6-minute walking distance of EG, but not of CG. There were also significant differences in the improvements of the DGI and the 6-minute walking distance between the groups. [Conclusion] Arm swing training had a positive effect on patients’ gait ability. Further studies are required to generalize the results of this study.Key words: Arm swing, Gait, Stroke     

体感游戏对帕金森病患者认知、步态的影响

目的 研究体感游戏对帕金森病（Parkinson's disease, PD）患者认知、步态的影响。方法 2018年6月至2020年1月,35例PD患者随机分成对照组（n=17）和实验组（n=18）,其中5例脱落,两组各剩15例。对照组接受传统的步态训练4周,实验组在接受传统的步态训练基础上的增加游戏训练4周,治疗前、后采用帕金森综合评分量表第三部分(Unified Parkinson's Disease Rating Scale Ⅲ, UPDRS Ⅲ）、Berg平衡量表（Berg Balance Scale, BBS）、蒙特利尔认知评估（Montreal Cognitive Assessment, MoCA）、双负荷计时“起立-行走”测试(double test the time up and go, TUGTDT),10米步行测试对PD患者进行评分。30例患者完成了干预其中对照组15例,实验组15例。结果 实验组及对照组UPDRS Ⅲ、BBS、TUGTDT测试治疗后均较治疗前改善(P<0.05),实验组优于对照组(P<0.05);实验组10米步行测试、MoCA评分治疗后较治疗前改善(P<0.05)。结论 传统步态训练结合游戏较单纯传统步态训练更能改善帕金森患者的步态、平衡及认知。