背景:基于传感器的干预(SI)已被建议作为改善老年人功能表现的替代康复治疗方法。然而,不同传感器技术在改善步态和平衡方面的有效性尚不清楚,需要进一步研究.
方法:十个数据库(学术搜索总理;护理和相关健康文献累积指数,完成;Cochrane中央对照试验登记册;MEDLINE;PubMed;WebofScience;公开论文;开放灰色;ProQuest;和灰色文献报告)已搜索截至2022年12月20日发表的相关文章。常规功能评估,包括定时启动(TUG)测试,正常的步态速度,伯格平衡量表(BBS),6分钟步行测试(6MWT),和下降疗效量表-国际(FES-I),作为反映步态和平衡表现的评价结果。我们首先对SI的有效性进行了荟萃分析,其中包括光学传感器(OPTS),感知传感器(PCPS),和可穿戴传感器(WS),与对照组相比,其中包括非治疗干预(NTI)和传统体育锻炼干预(TPEI)。我们进一步进行了分组分析,以比较SI(OPTS,PCPS,和WS)与TPEI组进行比较,并将每个SI亚型与对照(NTI和TPEI)和TPEI组进行比较。
结果:我们扫描了6255篇文章,并对58项选定的试验进行了荟萃分析(样本量=2713)。结果表明,SI组在改善步态和平衡性能方面明显优于对照组或TPEI组(p<0.000)。OPTS组和TPEI组之间的亚组荟萃分析显示,TUG检验的有效性存在明显的统计学差异(平均差异(MD)=-0.681s;p<0.000),正常步态速度(MD=4.244cm/s;p<0.000),BBS(MD=2.325;p=0.001),6MWT(MD=25.166m;p<0.000),和FES-I评分(MD=-2.036;p=0.036)。PCPS组与TPEI组在步态和平衡评估正常步态速度(MD=4.382cm/s;p=0.034)方面也有统计学上的显著差异。BBS(MD=1.874;p<0.000),6MWT(MD=21.904m;p<0.000),和FES-I得分(MD=-1.161;p<0.000),除了TUG测试(MD=-0.226s;p=0.106)。WS组与对照组之间的TUG检验(MD=-1.255s;p=0.101)或正常步态速度(MD=6.682cm/s;p=0.109)无统计学差异。
结论:SI与生物反馈对老年人混合人群的步态和平衡改善具有积极作用。具体来说,OPTS和PCPS组在改善步态和平衡性能方面在统计学上优于TPEI组。而只有BBS和6MWT的组比较才能达到最小的临床重要差异。此外,与对照组相比,WS组对步态和平衡改善没有统计学或临床上显着的积极作用。建议进行更多研究以验证特定SI的有效性。研究注册PROSPERO平台:CRD42022362817。2022年7月10日注册。
BACKGROUND: Sensor-based interventions (SI) have been suggested as an alternative rehabilitation treatment to improve older adults\' functional performance. However, the effectiveness of different sensor technologies in improving gait and balance remains unclear and requires further investigation.
METHODS: Ten databases (Academic Search Premier; Cumulative Index to Nursing and Allied Health Literature, Complete; Cochrane Central Register of Controlled Trials; MEDLINE; PubMed; Web of Science; OpenDissertations; Open grey; ProQuest; and Grey literature report) were searched for relevant articles published up to December 20, 2022. Conventional functional assessments, including the Timed Up and Go (TUG) test, normal gait speed, Berg Balance Scale (BBS), 6-Minute Walk Test (6MWT), and Falling Efficacy Scale-International (FES-I), were used as the evaluation outcomes reflecting gait and balance performance. We first meta-analyzed the effectiveness of SI, which included optical sensors (OPTS), perception sensors (PCPS), and wearable sensors (WS), compared with control groups, which included non-treatment intervention (NTI) and traditional physical exercise intervention (TPEI). We further conducted sub-group analysis to compare the effectiveness of SI (OPTS, PCPS, and WS) with TPEI groups and compared each SI subtype with control (NTI and TPEI) and TPEI groups.
RESULTS: We scanned 6255 articles and performed meta-analyses of 58 selected trials (sample size = 2713). The results showed that SI groups were significantly more effective than control or TPEI groups (p < 0.000) in improving gait and balance performance. The subgroup meta-analyses between OPTS groups and TPEI groups revealed clear statistically significant differences in effectiveness for TUG test (mean difference (MD) = - 0.681 s; p < 0.000), normal gait speed (MD = 4.244 cm/s; p < 0.000), BBS (MD = 2.325; p = 0.001), 6MWT (MD = 25.166 m; p < 0.000), and FES-I scores (MD = - 2.036; p = 0.036). PCPS groups also presented statistically significant differences with TPEI groups in gait and balance assessments for normal gait speed (MD = 4.382 cm/s; p = 0.034), BBS (MD = 1.874; p < 0.000), 6MWT (MD = 21.904 m; p < 0.000), and FES-I scores (MD = - 1.161; p < 0.000), except for the TUG test (MD = - 0.226 s; p = 0.106). There were no statistically significant differences in TUG test (MD = - 1.255 s; p = 0.101) or normal gait speed (MD = 6.682 cm/s; p = 0.109) between WS groups and control groups.
CONCLUSIONS: SI with
biofeedback has a positive effect on gait and balance improvement among a mixed population of older adults. Specifically, OPTS and PCPS groups were statistically better than TPEI groups at improving gait and balance performance, whereas only the group comparison in BBS and 6MWT can reach the minimal clinically important difference. Moreover, WS groups showed no statistically or clinically significant positive effect on gait and balance improvement compared with control groups. More studies are recommended to verify the effectiveness of specific SI. Research registration PROSPERO platform: CRD42022362817. Registered on 7/10/2022.