| 王佳,张清芳,洪雅晴,杨泽雨,柯美华,支亮,张婧欹,龙建军.认知-运动双任务训练对脑卒中患者步行稳定性影响的Meta分析[J].中国康复,2025,40(6):362-372 |
| 认知-运动双任务训练对脑卒中患者步行稳定性影响的Meta分析 |
| Effect of cognitive motor dual task training on walking stability in stroke patients: a Meta-analysis |
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| DOI：10.3870/zgkf.2025.06.008 |
| 中文关键词: 认知-运动双任务训练 脑卒中 步行稳定性 跌倒 Meta分析 |
| 英文关键词: cognitive-motor dual-task training stroke walking stability falls Meta-analysis |
| 基金项目:深圳市三名工程“南京医科大学励建安团队”资助项目（SZSM202111010）；国际化基础研究和应用基础研究机构建设计划（HTHZQSWS-KCCYB-2023060）；广东省普通高校重点领域专项 (No. 2024ZDZX2083) |
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| 中文摘要: |
| 目的：探讨认知-运动双任务训练对脑卒中患者步行稳定性的影响。方法：计算机检索中国知网、万方数据库、Pubmed、Web of Science、Cochrane library等中英文文献数据库关于认知-运动双任务训练对脑卒中患者步行稳定性影响相关的随机对照试验。检索时间为数据库建库至2024年8月20日。由2名研究人员独立对纳入文献进行筛选、数据提取和质量评价。采用Revman5.4软件进行Meta分析。结果：共纳入19篇随机对照试验，共823例患者。Meta分析结果显示，与单任务康复组相比，认知-运动双任务组可改善患者平衡功能［MD=3.94,95%CI（2.84,5.05）,P＜0.0001］、Fugl-Meyer下肢运动功能评分量表（FMA-LE）评分［MD=2.19,95%CI（0.57，3.81），P=0.008］、单任务步速［MD=0.07,95%CI（0.04,0.09）,P＜0.0001］、双任务步速［MD=0.12,95%CI（0.09,0.15）,P＜0.0001］、单任务步长［MD=0.03,95%CI（0.00,0.06）,P=0.04］、双任务步长［MD=0.01,95%CI（0.01,0.02），P=0.0008］，降低患者跌倒发生率［OR=0.32,95%CI（0.11,0.87）,Z=2.24，P=0.03］，以上差异均具有统计学意义（P＜0.05）；2组MMSE量表评分［MD=-0.65,95%CI（-5.82,4.51）,P=0.80］，差异无统计学意义。结论：认知-运动双任务训练可以有效地改善脑卒中患者单任务步长、双任务步长、单任务步速、双任务步速、平衡功能及FMA-LE评分，并降低跌倒发生率，提升其步态稳定性，但对于认知功能的改善情况尚需更多研究进一步验证。 |
| 英文摘要: |
| Objective: To explore the impact of cognitive-motor dual-task training on the walking stability of stroke patients. Methods: Computerized searches were conducted in Chinese and English literature databases such as CNKI, Wanfang Database, Pubmed, Web of Science, and Cochrane Library for randomized controlled trials related to the impact of cognitive-motor dual-task training on the walking stability of stroke patients. The search time was from the establishment of the database to August 20, 2024. Two researchers independently screened the included literature, extracted data, and evaluated the quality. Meta-analysis was performed using Revman 5.4 software. Results: A total of 19 randomized controlled trials were included, involving 823 patients. Meta-analysis results showed that compared with the single-task rehabilitation group, the cognitive-motor dual-task group could improve patients’ balance function ［MD = 3.94, 95%CI (2.84, 5.05), P<0.0001］, FMA-LE score ［MD = 2.19, 95%CI (0.57, 3.81), P=0.008］, single-task walking speed ［MD = 0.07, 95%CI (0.04, 0.09), P<0.0001］, dual-task walking speed ［MD = 0.12, 95%CI (0.09, 0.15), P<0.0001］, single-task step length ［MD = 0.03, 95%CI (0.00, 0.06), P=0.04］, and dual-task step length ［MD = 0.01, 95%CI (0.01, 0.02), P=0.0008］. The incidence of falls was reduced ［OR = 0.32, 95%CI (0.11, 0.87), Z = 2.24, P=0.03］. The above differences were statistically significant (P<0.05). There was no statistically significant difference in the MMSE scale score between the two groups ［MD =-0.65, 95%CI (-5.82, 4.51), P=0.80］ (P>0.05). Conclusion: Cognitive-motor dual-task training can bet-ter improve the single-task step length, dual-task step length, single-task walking speed, dual-task walking speed, balance function, and FMA-LE score of stroke patients, and reduce the incidence of falls and improve their gait stability. However, more research is needed to further verify the improvement of cognitive function. |
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