Intervention Review

Force platform feedback for standing balance training after stroke

  1. Ruth E Barclay-Goddard1,*,
  2. Ted J Stevenson2,
  3. William Poluha3,
  4. Michael Moffatt4,
  5. Shayne P Taback5

Editorial Group: Cochrane Stroke Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 22 DEC 2003

DOI: 10.1002/14651858.CD004129.pub2

Database Title

Additional Information

How to Cite

Barclay-Goddard RE, Stevenson TJ, Poluha W, Moffatt M, Taback SP. Force platform feedback for standing balance training after stroke. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD004129. DOI: 10.1002/14651858.CD004129.pub2.

Author Information

  1. 1

    University of Manitoba, Department of Physical Therapy, School of Medical Rehabilitation, Winnipeg, Manitoba, Canada

  2. 2

    St. Boniface General Hospital, Department of Rehabilitation Services, Winnipeg, Manitoba, Canada

  3. 3

    University of Manitoba, Neil John Maclean Health Sciences Library, Winnipeg, Manitoba, Canada

  4. 4

    Winnipeg Regional Health Authority, Research & Applied Learning, Winnipeg, Manitoba, Canada

  5. 5

    University of Manitoba, Department of Pediatrics and Child Health, Winnipeg, Manitoba, Canada

*Ruth E Barclay-Goddard, Department of Physical Therapy, School of Medical Rehabilitation, University of Manitoba, School of Medical Rehabiltation, R106-771 McDermot Avenue, Winnipeg, Manitoba, R3E 0T6, Canada. barclayg@ms.umanitoba.ca.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Standing balance deficits are common in individuals after stroke. One way to address these deficits is to provide the individual with feedback from a force platform while balance activities are performed. The feedback can take visual and/or auditory form.

Objectives

To determine if visual or auditory force platform feedback improves the clinical and force platform standing balance outcomes in clients with stroke.

Search methods

We searched the Cochrane Stroke Group trials register (last searched December 2003), and the following electronic bibliographic databases: the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2003), MEDLINE (1966 to May 2003), EMBASE (1974 to May 2003), CINAHL (1982 to May 2003), PEDro (May 2003), CIRRIE (May 2003) and REHABDATA (May 2003). Reference lists of articles were reviewed and manufacturers of equipment were contacted.

Selection criteria

Randomized controlled trials comparing force platform with visual feedback and/or auditory feedback to other balance treatments.

Data collection and analysis

Two reviewers independently assessed trials for inclusion, methodological quality, and data extraction. Trials were combined for meta-analysis according to outcome and type of feedback.

Main results

We included seven trials (246 participants). Force platform feedback did not improve clinical measures of balance when moving or walking (Berg Balance Scale and Timed Up and Go). Significant improvements in laboratory force platform indicators of stance symmetry were found for regimens using visual feedback (standardised mean difference (SMD) -0.68, 95% confidence interval (CI) -1.31 to -0.04, p = 0.04) and the concurrent visual and auditory feedback (weighted mean difference (WMD) -4.02, 95% CI -5.99 to -2.04, p = 0.00007). There were no significant effects on laboratory postural sway indicators, clinical outcomes or measures of function at follow-up assessment.

Authors' conclusions

Force platform feedback (visual or auditory) improved stance symmetry but not sway in standing, clinical balance outcomes or measures of independence.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Force platform feedback for standing balance training after stroke

Feedback from a force platform improves standing balance but the impact on independence is unclear. People who have had a stroke often experience problems with standing balance. Impaired standing balance is often treated with balance exercises suggested by a physiotherapist. Exercises are sometimes given with feedback from a force platform to indicate the person's standing position. The results of seven clinical trials indicated that providing feedback from a force platform resulted in patients standing more evenly but did not improve balance during active functional activities, nor did it improve overall independence.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

中風後以力平台(force platform)回饋訓練站立平衡

站立平衡障礙在人們發生中風後是常見的。一種解決這些障礙的辦法是在進行平衡活動時，提供病人來自力平台的回饋。這種回饋可以採取視覺和(或)聽覺的形式。

目標

要確定是否視覺或聽覺力平台回饋能改善中風病人臨床和力平台站立平衡的結果。

搜尋策略

我們搜尋了Cochrane Cochrane Stroke Group trials register(2003年12月的最後一次搜尋)及以下的電子文獻目錄資料庫：Cochrane Central Register of Controlled Trials(The Cochrane Library Issue 3, 2003)、MEDLINE(1966年至2003年5月)、EMBASE(1974 年至2003年5月)、CINAHL(1982年至2003年5月)、PEDro(2003年5月)、CIRRIE(2003年5月)和REHABDATA(2003年5月)。我們審查了文章的參考文獻目錄，並且與設備製造商取得聯繫。

選擇標準

比較採用視覺回饋和(或)聽覺回饋的力平台與其他平衡治療的隨機對照試驗。

資料收集與分析

兩位回顧作者獨立地評估試驗是否納入、試驗的方法學品質、並擷取試驗的數據。根據結果與回饋的類型將試驗合併以做為後設分析。

主要結論

我們收納了7個試驗(共246位受試者)。力平台回饋並沒有改善移動或行走時之平衡的臨床測量結果(Berg Balance Scale and Timed Up and Go)。採用視覺回饋(standardised mean difference (SMD) −0.68, 95% confidence interval (CI) −1.31 to −0.04, p = 0.04)和同時進行視覺和聽覺回饋(weighted mean difference (WMD) −4.02, 95% CI −5.99 to −2.04, p = 0.00007)的方式時，發現在站姿對稱性的實驗力平台指標上有顯著的改善。在追蹤評估時，實驗中的姿勢橫向移動指標、臨床結果或功能的測量上並沒有顯著的效果。

作者結論

力平台回饋(視覺或聽覺)能改善站姿的對稱性，但無法改善在站立時的橫向移動、臨床平衡結果或獨立的程度。

翻譯人

本摘要由奇美醫院張偉倫翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

力平台回饋能改善站立平衡，但對獨立性的影響是不清楚的。中風病患通常會有站立平衡方面的問題。物理治療師通常會建議以平衡運動來治療站立平衡障礙。有時在運動中加入力平台回饋能指出病人站立的姿勢。7個臨床試驗的結果指出提供力平台回饋能使病人站立的更為平穩；但無法改善自主功能性活動時的平衡，也無法改善整體的獨立性。

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