Effectiveness of external auditory rhythm walking training after stroke - literature review

Uvod: Vadba hoje z ritmom naj bi izboljšala različne parametre hoje, motorične sposobnosti, toleranco na bolečino, motivacijo, pozornost, spomin, interakcijo z okoljem in kakovost življenja po možganski kapi. Namen: Želeli smo ugotoviti učinkovitost vadbe hoje z ritmom na hojo po možganski kapi v primerjavi s standardno vadbo hoje po tleh ali standardno fizioterapevtsko obravnavo. Metode dela: Randomizirane kontrolirane raziskave smo iskali v podatkovnih zbirkah PubMed in PEDro, v angleškem jeziku. Dodatno so bili pregledani seznami literature relevantnih preglednih člankov in protokolov. Rezultati: V pregled literature smo na podlagi vključitvenih in izključitvenih meril vključili sedem raziskav, v katerih so zajeli 144 preiskovancev. Vadba hoje z ritmom se je izkazala za učinkovitejšo v primerjavi s standardno vadbo hoje predvsem glede dolžine koraka in hitrosti hoje po tleh. V dveh raziskavah, kjer so izvajali vadbo hoje z ritmom, kot dodatek k standardni fizioterapevtski obravnavi, se je ta izkazala za učinkovitejšo glede hitrosti hoje v primerjavi s standardno vadbo hoje po tleh. Izboljšanje v skupini po vadbi hoje z ritmom se je pokazalo tudi v eni raziskavi brez standardne fizioterapevtske obravnave. Vadba hoje z ritmom ni imela posebnega učinka na premičnost, ravnotežje in motorične funkcije. Razprava in zaključek: Vadba hoje z ritmom je učinkovita metoda pri izboljšanju različnih parametrov hoje po možganski kapi. Kot pravijo priporočila, je pri pacientih z zmerno stopnjo okvare priporočljiva izvedba 30 minut na sejo, štirikrat tedensko in štiri tedne. Izvajati jo je potrebno poleg standardne vadbe hoje po tleh ter med vsako obravnavo vaditi vadbo hoje z ritmom in brez njega. Ritem je na začetku potrebno prilagoditi ritmu korakov (kadenci) glede na posameznega pacienta, nato pa ga postopoma stopnjevati za 5–10 % po 5–25 minutah vadbe z ritmom. Učinkovitost vadbe hoje z ritmom je bila potrjena kot dodatek k standardni fizioterapevtski obravnavi ali brez nje, odvisno od parametra hoje, ki ga želimo izboljšati.Introduction: Walking with external auditory rhythm is expected to improve various parameters of walking, motor skills, pain tolerance, motivation, attention, memory, interaction with the environment and quality of life after stroke. Purpose: We wanted to determine the effectiveness of walking with external auditory rhythm on walking after stroke compared to standard floor walking training or standard physiotherapy treatment. Methods: Randomised controlled trials were searched in PubMed and PEDro, in English. In addition, the reference lists of relevant review articles and protocols were reviewed. Results: Seven studies with 144 subjects were included in the literature review based on inclusion and exclusion criteria. Walking with an external auditory rhythm was found to be more effective than standard walking training, especially in terms of stride length and walking speed on the floor. In two studies, where external auditory rhythm walking training was used as an adjunct to standard physiotherapy treatment, it was found to be more effective in terms of walking speed compared to standard floor walking training. Improvement in the group after walking on the floor with external auditory rhythm was also shown in one study without standard physiotherapy treatment. Exercising walking on the floor with an external auditory rhythm had no specific effect on mobility, balance and motor function. Discussion and conclusion: Walking training on the floor with an external auditory rhythm is an effective method for improving various walking parameters after stroke. According to the recommendations, 30 minutes per session, four times a week for four weeks, is recommended for patients with a moderate degree of impairment. It should be practised in addition to the standard floor-walking exercise, and with and without an external auditory rhythm during each session. The rhythm should be adapted to the rhythm of the steps (cadence) according to the individual patient at the beginning, and then gradually increased by 5-10 % after 5-25 minutes of training with the external auditory rhythm. The effectiveness of rhythmic gait training has been validated, as an adjunct to standard physiotherapy treatment or without, depending on the gait parameter to be improved