《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (5): 563-573.doi: 10.3969/j.issn.1006-9771.2021.05.009
收稿日期:
2020-11-24
修回日期:
2021-03-19
出版日期:
2021-05-25
发布日期:
2021-05-26
通讯作者:
陈亮
E-mail:cullencl@126.com
作者简介:
郭静霞(1997-),女,汉族,湖北十堰市人,硕士研究生,主要研究方向:运动与健康|陈亮(1983-),男,山东曲阜市人,博士,副教授,主要研究方向:运动训练理论。
基金资助:
Jing-xia GUO1,2,Liang CHEN1,2(),Qi-chao YU2,Yu WU2
Received:
2020-11-24
Revised:
2021-03-19
Published:
2021-05-25
Online:
2021-05-26
Contact:
Liang CHEN
E-mail:cullencl@126.com
Supported by:
摘要: 系统评价运动对预防老年人跌倒的疗效。 检索1980年至2020年7月Web of Science、PubMed、Cochrane Library、中国知网数据库有关运动对预防老年人跌倒的随机对照试验,采用Review Manager 5.3对纳入文献进行质量评价,应用R-Studio和Addis 1.16.6软件进行网状Meta分析。 纳入172项研究,共9种运动干预手段。运动与认知结合训练减少老年人跌倒率最有效(OR = 0.26, 95%CI 0.14~0.49, P < 0.05);全身振动结合运动训练对提高老年人Berg平衡量表评分(d = 6.3, 95%CI 3.5~9.2, P < 0.05)和计时起立-行走测试成绩(d = -4.5, 95%CI -6.8~-2.1, P < 0.05)方面最有效;血流限制训练对提高下肢肌力最有效(d = 12, 95%CI 7.4~16, P < 0.05)。 认知与运动结合训练是降低老年人跌倒率最优先推荐的运动方式,太极拳和组合运动方式次之,单纯步态训练或抗阻训练效果最差。多种新型干预手段(血流限制、全身振动与运动结合、体感游戏等)对提高老年人身体功能有一定优势,可继续深入研究。
中图分类号:
郭静霞,陈亮,余启超,吴渔. 运动对预防老年人跌倒效果的网状Meta分析[J]. 《中国康复理论与实践》, 2021, 27(5): 563-573.
Jing-xia GUO,Liang CHEN,Qi-chao YU,Yu WU. Efficacy of Exercise on Fall in Old Adults: A Network Meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(5): 563-573.
表1
运动干预的核心内容"
运动(ICF编码) | 定义 | 机制 | 评价指标 |
---|---|---|---|
BFR (d420、b730) | 通过特殊加压装置对肢体施加140~200 mmHg压强,以增强肌力 | 使静脉血流闭塞,同时部分阻塞动脉血流 | TUGT、下肢肌力 |
CMM (d450、d410、d420、b730) | 将心理学理论和范式与游戏化思维结合,以各种多任务练习为特色设计的训练 | 增强记忆力、注意力和自我保护意识等,提高对任务相关刺激的选择性反应 | 跌倒率、BBS、TUGT、下肢肌力 |
MT (d450、d410、d420、b730) | 将平衡、抗阻、有氧等多种形式的运动进行组合 | 多种形式运动对力量、耐力、平衡稳定性等产生交互影响 | 跌倒率、BBS、TUGT、下肢肌力 |
RT (d450、d420、b730) | 采用外部负荷对特定或全身肌群进行的力量训练 | 使肌肉面积增加,质量提高,调节中枢神经系统兴奋性 | 跌倒率、TUGT、下肢肌力 |
PE (d450、d410、d420、b730) | 不进行抗阻练习且采用单一形式的运动 | 对受试者缺失的能力进行针对性训练 | 跌倒率、BBS、TUGT、下肢肌力 |
TC (d450、d410、d420、b730) | 一种中国传统拳术 | 增强核心肌群力量,并通过身心调节提高练习者的协调性 | 跌倒率、BBS、TUGT、下肢肌力 |
WBV (d450、d410、d420、b730) | 将频率为25~35 Hz的低强度机械振动作用于身体,引起全身肌肉震荡的训练方法 | 肌肉发生周期性拉长与缩短,进而兴奋肌梭,引起骨骼肌收缩 | 跌倒率、BBS、TUGT、下肢肌力 |
PWBV (d410、d420、b730) | 将WBV与RT、平衡等训练形式相结合 | 将全身振动引起的被动收缩与主动收缩相结合,弥补单一运动的不足 | BBS、TUGT、下肢肌力 |
Wii (d410、d420、b730) | 通过肢体运动操控电子游戏的交互式训练方法 | 通过多样化的运动增加训练趣味性,提高训练动机和注意力 | BBS、TUGT、下肢肌力 |
表2
纳入文献的基本特征"
基本信息 | 文献数(n) | 研究对象数(n) | |
---|---|---|---|
年龄(岁) | 60~75 | 87 | 9629 |
≥ 75 | 85 | 11009 | |
运动方式 | BFR | 203 | |
CMM | 477 | ||
MT | 71 | 11194 | |
PE | 2325 | ||
RT | 1491 | ||
TC | 4422 | ||
WBV | 1666 | ||
PWBV | 185 | ||
Wii | 518 | ||
运动干预时间(周) | ≤ 12 | 90 | 5764 |
> 12 | 82 | 14874 | |
每周运动时间(h) | < 2 | 4935 | |
2~< 3 | 62 | 8589 | |
≥ 3 | 77 | 7114 | |
健康状况 | 无特殊疾病 | 127 | 17436 |
帕金森病 | 827 | ||
脑卒中/脑卒中 | 788 | ||
骨质疏松/关节炎 | 600 | ||
其他 | 987 | ||
运动场所 | 家庭 | 3907 | |
小组/社区/疗养院 | 98 | 14273 | |
跑步机/特殊辅助仪器 | 2458 | ||
结局指标 | 跌倒率 | 12065 | |
BBS | 3193 | ||
TUGT | 84 | 7117 | |
下肢肌力 | 66 | 6021 | |
文献质量评价 | A | 517 | |
B | 168 | 20121 | |
C | 0 | 0 |
1 | 齐红倩,杨燕. 人口老龄化、养老保障水平与我国养老保险基金结余[J]. 南京社会科学, 2020, 8(2): 11-21. |
QI H Q, YANG Y. The aging of population, the level of pension security and the balance of pension fund in China [J]. J Nanjing Social Sci, 2020, 8(2): 11-21. | |
2 | CHENG P, TAN L, NING P, et al. Comparative effectiveness of published interventions for elderly fall prevention: a systematic review and network meta-analysis [J]. Int J Environ Res Public Health, 2018, 15(3): 498. |
3 | CARTY C P, CRONIN N J, NICHOLSON D, et al. Reactive stepping behaviour in response to forward loss of balance predicts future falls in community-dwelling older adults [J]. Age Ageing, 2015, 44(1): 109-115. |
4 | World Health Organization. WHO Global Report on Falls Prevention in Older Age [R]. Geneva: World Health Organization, 2007. |
5 | LEIROS-RODRÍGUEZ R, GARCÍA-SOIDAN J L. Balance training in elderly women using public parks [J]. J Women Aging, 2014, 26(3): 207-218. |
6 | DE CARVALHO BASTONE A, NOBRE L, DE SOUZA MOREIRA B, et al. Independent and combined effect of home-based progressive resistance training and nutritional supplementation on muscle strength, muscle mass and physical function in dynapenic older adults with low protein intake: a randomized controlled trial [J]. Arch Gerontol Geriatr, 2020, 89: 104098. |
7 | VOUKELATOS A, MEROM D, SHERRINGTON C, et al. The impact of a home-based walking programme on falls in older people: the Easy Steps randomised controlled trial [J]. Age Ageing, 2015, 44(3): 377-383. |
8 | FISSEHA B, JANAKIRAMAN B, YITAYEH A, et al. Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences [J]. J Exerc Rehabil, 2017, 13(1): 23-29. |
9 | KARINKANTA S, KANNUS P, UUSI-RASI K, et al. Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study [J]. Age Ageing, 2015, 44(5): 784-789. |
10 | CHO Y H, MOHAMED O, WHITE B, et al. The effects of a multicomponent intervention program on clinical outcomes associated with falls in healthy older adults [J]. Aging Clin Exp Res, 2018, 20(4): 763-775. |
11 | LAM F M, CHAN P F, LIAO L R, et al. Effects of whole-body vibration on balance and mobility in institutionalized older adults: a randomized controlled trial [J]. Clin Rehabil, 2018, 32(4): 462-472. |
12 | CLARKSON M J, CONWAY L, WARMINGTON S A. Blood flow restriction walking and physical function in older adults: a randomized control trial [J]. J Sci Med Sport, 2017, 20(12): 1041-1046. |
13 | CHO H K, LEE K J, SONG C H. Virtual-reality balance training with a video-game system improves dynamic balance in chronic stroke patients [J]. Tohoku J Exp Med, 2012, 228(1): 69-74. |
14 | LIAO Y Y, CHEN I H, LIN Y L, et al. Effects of virtual reality-based physical and cognitive training on executive function and dual-dask gait performance in older adults with mild cognitive impairment: a randomized control trail [J]. Front Aging Neurosci, 2019, 11: 162. |
15 | NYMAN S R, VICTOR C R. Older people's participation in and engagement with falls prevention interventions in community settings: an augment to the Cochrane systematic review [J]. Age Ageing, 2012, 41(1): 16-23. |
16 | SMITH E, CUSACK T, BLAKE C. The effect of a dual task on gait speed in community dwelling older adults: a systematic review and meta-analysis [J]. Gait Posture, 2016, 44: 250-258. |
17 | KURZ I, GIMMON Y, SHAPIRO A, et al. Unexpected perturbation training improves balance control and voluntary stepping times in older adults: a double blind randomized control trial [J]. BMC Geriatrics, 2016, 16: 58-65. |
18 | KO S U, JEROME G J, SIMONSICK E M, et al. Differential associations between dual-task walking abilities and usual gait patterns in healthy older adults-results from the Baltimore Longitudinal Study of Aging [J]. Gait Posture, 2018, 63(6): 63-67. |
19 | RICE L A, OUSLEY C, SOSNOFF J J. A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults [J]. Disabil Rehabil, 2015, 37(19): 1697-1705. |
20 | WAGNER L M, SCOTT V, SILVER M. Current approaches to fall risk assessment in nursing homes [J]. Geriatr Nurs, 2011, 32(4): 238-244. |
21 | HORLINGS C G, ENGELEN B G VAN, ALLUM J H, et al. A weak balance: the contribution of muscle weakness to postural instability and falls [J]. Nat Clin Pract Neurol, 2008, 4(9): 504-515. |
22 | STEGEMÖLLER E L, BUCKLEY T A, PITSIKOULIS C, et al. Postural instability and gait impairment during obstacle crossing in Parkinson's disease [J]. Arch Phys Med Rehabil, 2012, 93(4): 703-709. |
23 | VERGHESE J, AMBROSE A F, LIPTON R B, et al. Neurological gait abnormalities and risk of falls in older adults [J]. J Neurol, 2010, 257(3): 392-398. |
24 | DEL-PINO-CASADO R, OBRERO-GAITÁN E, LOMAS-VEGA R. The effect of Tai Chi on reducing the risk of falling: a systematic review and meta-analysis [J]. Am J Chin Med, 2016, 44(5): 895-906. |
25 | HUANG Z G, FENG Y H, LI Y H, et al. Systematic review and meta-analysis: Tai Chi for preventing falls in older adults [J]. BMJ Open, 2017, 7(2): e013661. |
26 | ZHANG Y, ZHANG Y, DU S, et al. Exercise interventions for improving physical function, daily living activities and quality of life in community-dwelling frail older adults: a systematic review and meta-analysis of randomized controlled trials [J]. Geriatr Nurs, 2020, 41(3): 261-273. |
27 | SHERRINGTON C, MICHALEFF Z A, FAIRHALL N, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis [J]. Br J Sports Med, 2017, 51(24): 1750-1758. |
28 | JEPSEN D B, THOMSEN K, HANSEN S, et al. Effect of whole-body vibration exercise in preventing falls and fractures: a systematic review and meta-analysis [J]. BMJ Open, 2017, 7(12): e018342. |
29 | 朱晓凤. 不同频率全身振动训练对老年人平衡和核心稳定性的影响[J]. 中国康复理论与实践, 2020, 26(3): 291-294. |
ZHU X F. Effects of whole-body vibration training with different frequency on balance and core stability for old adults [J]. Chin J Rehabil Theory Pract, 2020, 26(3): 291-294. | |
30 | 颜航,镇雪婷,黄青青,等. 全身振动训练对老年人平衡能力效果的Meta分析[J]. 中华护理杂志, 2020, 55(2): 243-249. |
YAN H, ZHEN X T, HUANG Q Q, et al. Effectiveness of whole-body vibration training on balance ability of the elderly: a meta-analysis [J]. Chin J Nurs, 2020, 55(2): 243-249. | |
31 | 朱玲玲,绳宇. 血管性轻度认知障碍老年人双重任务行走下步态参数特征与跌倒的关系[J]. 中国康复理论与实践, 2020, 26(4): 467-471. |
ZHU L L, SHENG Y. Gait characteristics under dual-task condition and their relationship with fall among old patients with vascular mild cognitive impairment [J]. Chin J Rehabil Theory and Pract, 2020, 26(4): 467-471. | |
32 | 刘立,张庭然,罗炯,等. 老年人与年轻人双重任务下阶梯行走步态特征比较[J]. 中国康复理论与实践, 2020, 26(3): 285-290. |
LIU L, ZHANG T R, LUO J, et al. Gait characteristics of staircase walking of old and young adults under dual task situation [J]. Chin J Rehabil Theory Pract, 2020, 26(3): 285-290. | |
33 | LIPARDO D S, ASERON A M C, KWAN M M, et al. Effect of exercise and cognitive training on falls and fall-related factors in older adults with mild cognitive impairment: a systematic review [J]. Arch Phys Med Rehabil, 2017, 98(10): 2079-2096. |
34 | Bahureska L, Najafi B, Saleh A, et al. The impact of mild cognitive impairment on gait and balance: a systematic review and meta-analysis of studies using instrumented assessment [J]. Gerontology, 2017, 63(1): 67-83. |
35 | Donath L, Rössler R, Faude O. Effects of virtual reality training (Exergaming) compared to alternative exercise training and passive control on standing balance and functional mobility in healthy community-dwelling seniors: a meta-analytical review [J]. Sports Med, 2016, 46(9): 1293-1309. |
36 | 梁明,魏珍,谢荣,等. 虚拟现实技术对老年人平衡功能康复效果的Meta分析[J]. 中国康复理论与实践, 2020, 26(3): 278-284. |
LIANG M, WEI Z, XIE R, et al. Virtual reality training for balance function for old adults: a meta-analysis [J]. Chin J Rehabil Theory Pract, 2020, 26(3): 278-284. | |
37 | FERREIRA C B, TEIXEIRA P D S, ALVES DOS SANTOS G, et al. Effect of a 12-week exercise training program on physical function in institutionalized frail elderly [J]. J Aging Res, 2018, 7(2): 181-193. |
38 | JADCZAK A D, MAKWANA N, LUSCONBE-MARSH N, et al. Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic review [J]. JBI, 2018, 16(3): 752-775. |
39 | BOONGIRD C, KEESUKPHAN P, PHIPHADTHAKUSOLKUL S, et al. Effects of a simple home-based exercise program on fall prevention in older adults: a 12-month primary care setting, randomized controlled trial [J]. Geriatr Gerontol Int, 2017, 17(11): 2157-2163. |
40 | BERG K O, WOOD-DAUPHINEE S L, WILLIAMS J I. The balance scale: reliability assessment with elderly residents and patients with an acute stroke [J]. Scand J Rehabil Med, 1995, 27: 27-36. |
41 | LAURA M D M, HOTTA ANSAI J, GIUSTI ROSSI P, et al. Performance of an adapted version of the Timed Up-and-Go Test in people with cognitive impairments [J]. J Mot Behav, 2019, 51(6): 647-654. |
42 | LUAN X, TIAN X, ZHANG H, et al. Exercise as a prescription for patients with various diseases [J]. J Sport Health Sci, 2019, 8(5): 422-441. |
43 | 姜静远,邱卓英,王国祥,等. 世界卫生组织国际健康分类家族在康复中系统应用的方案与路线图[J]. 中国康复理论与实践, 2020, 26(11): 1241-1255. |
JIANG J Y, QIU Z Y, WANG G X, et al. Systematic implementation of World Health Organization Family International Classifications in rehabilitation: protocol and roadmap [J]. Chin J Rehabil Theory Pract, 2020, 26(11): 1241-1255. | |
44 | COHEN J. Statistical Power Analysis for the Behavioral Sciences [M]. 2nd ed. New Jersey: Lawrence Erlbaum Associates, 1988. |
45 | SAHIN U K, KIRDI N, BOZOGLU E, et al. Effect of low-intensity versus high-intensity resistance training on the functioning of the institutionalized frail elderly [J]. Int J Rehabil Res, 2018, 36(12): 346-363. |
46 | DE SOUTO BARRETO P, ROLLAND Y, VELLAS B. et al. Association of long-term exercise training with risk of falls, fractures, hospitalizations, and mortality in older adults: a systematic review and meta-analysis [J]. JAMA Intern Med, 2019, 179(3): 394-405. |
47 | BRYK F F, REIS A C DOS, FINGERHUT D, et al. Exercises with partial vascular occlusion in patients with knee osteoarthritis: a randomized clinical trial [J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(5): 1580-1586. |
48 | 瞿超艺,覃飞,徐旻霄,等. 加压训练在体育应用时的禁忌与风险防范[J]. 中国体育科技, 2019, 55(5): 3-7. |
QU C Y, QIN F, XU M X, et al. KAATSU training taboo and risk prevention in the application of sports [J]. Chin Sport Sci Technol, 2019, 55(5): 3-7. | |
49 | AVELAR N C, SIMÃO A P, TOSSIGE-GOMES R, et al. The effect of adding whole-body vibration to squat training on the functional performance and self-report of disease status in elderly patients with knee osteoarthritis: a randomized, controlled clinical study [J]. J Altern Complement Med, 2011, 17(12): 1149-1155. |
50 | LI F, HARMER P, FITZGERALD K, et al. Tai Chi and postural stability in patients with Parkinson's disease [J]. N Engl J Med, 2012, 366(6): 511-519. |
51 | MELZER I, BENJUYA N, KAPLANSKI J. Effect of physical training on postural control of elderly [J]. Harefuah, 2005, 114(12): 839-844. |
52 | MADUREIRA M M, TAKAYAMA L, GALLINARO A L, et al. Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial [J]. Osteoporos Int, 2007, 18(4): 419-425. |
53 | LAUFER Y, DAR G, KODESH E. Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review [J]. Clin Interv Aging, 2014, 9: 1803-1813. |
54 | GSCHWIND Y J, SCHOENE D, LORD S R, et al. The effect of sensor-based exercise at home on functional performance associated with fall risk in older people: a comparison of two exergame interventions [J]. Eur Rev Aging Phys Act, 2015, 12: 11. |
55 | TROMBETTI A, HARS M, HERRMANN F R, et al. Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial [J]. Arch Intern Med, 2011, 171(6): 525-533. |
56 | LIPARDO D S, TSANG W W. Effects of combined physical and cognitive training on fall prevention and risk reduction in older persons with mild cognitive impairment: a randomized controlled study [J]. Clin Rehabil, 2020, 34(6): 773-782. |
57 | BOGAERTS A, DELECLUSE C, BOONEN S, et al. Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial [J]. Gait Posture, 2011, 33(3): 466-472. |
58 | EBRAHIM S, THOMPSON P W, BASKARAN V, et al. Randomized placebo-controlled trial of brisk walking in the prevention of postmenopausal osteoporosis [J]. Age Ageing, 1997, 26(4): 253-260. |
59 | FABER M J, BOSSCHER R J, CHIN A PAW M J, et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial [J]. Arch Phys Med Rehabil, 2006, 87(7): 885-896. |
60 | HIRASE T, INOKUCHI S, MATSUSAKA N, et al. Effects of a balance training program using a foam rubber pad in community-based older adults: a randomized controlled trial [J]. J Geriatr Phys Ther, 2015, 38(2): 62-70. |
[1] | 周治宁, 周容, 肖燕文, 王博文, 吕娇娇, 刘宇. 多靶区经颅直流电刺激对健康成年人工作记忆-姿势控制双任务表现的影响[J]. 《中国康复理论与实践》, 2024, 30(1): 21-28. |
[2] | 王航宇, 葛可可, 范永红, 都丽露, 邹敏, 封磊. 基于ICD-11和ICF主动式音乐疗法改善认知障碍老年人认知功能的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 36-43. |
[3] | 葛可可, 范永红, 王航宇, 都丽露, 李长江, 邹敏. 失眠老年人正念干预健康效益的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 54-60. |
[4] | 王昊懿, 史亚伟, 鲁俊, 许光旭. 主观垂直感知障碍对脑卒中患者功能影响的回顾性研究[J]. 《中国康复理论与实践》, 2024, 30(1): 68-73. |
[5] | 陈珺雯, 陈谦, 陈程, 李淑月, 刘玲玲, 吴存书, 龚翔, 鲁俊, 许光旭. 改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 74-80. |
[6] | 魏梦力, 钟亚平, 周易文, 桂辉贤, 关烨明, 于婷婷. 单侧前交叉韧带重建患者步行双侧下肢肌肉协同模式差异[J]. 《中国康复理论与实践》, 2024, 30(1): 95-104. |
[7] | 王贺, 韩靓, 阚梦凡, 于少泓. 电刺激治疗脑卒中后肩手综合征有效性的系统评价与Meta分析[J]. 《中国康复理论与实践》, 2023, 29(9): 1048-1056. |
[8] | 张冠聪, 黄秋晨, 顾蕊, 刘四海, 胡春英, 刘克敏. 不同神经肌肉训练方法对早期膝骨关节炎患者疼痛和运动功能效果的比较[J]. 《中国康复理论与实践》, 2023, 29(9): 1090-1097. |
[9] | 杨雅楠, 穆丽萍, 邢凤梅, 薛新宏, 王晓光, 陶徉聿, 孙竹梅, 张小丽. 基于计划行为理论的干预对肌少症老年人肌肉衰减状况及平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 869-874. |
[10] | 孙藤方, 任梦婷, 杨琳, 王耀霆, 王红雨, 闫兴洲. 高压氧治疗联合重复外周磁刺激干预脑卒中患者踝运动功能和平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 875-881. |
[11] | 马圣楠, 柯竟悦, 董洪铭, 李建萍, 张洪浩, 刘超, 沈双, 李古强. 核心稳定性训练干预前交叉韧带重建术后动态平衡及表面肌电的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 882-889. |
[12] | 王亚楠, 刘西花. 脑卒中偏瘫患者主观和客观平衡功能测量的相关性及预测效能[J]. 《中国康复理论与实践》, 2023, 29(8): 890-895. |
[13] | 蒋长好, 黄辰, 高晓妍, 戴元富, 赵国明. 神经反馈训练对老年人认知功能效果的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 903-909. |
[14] | 魏晓微, 杨剑, 魏春艳, 贺启令. 学校环境下适应性体育课程促进智力与发展性残疾儿童心理运动发展的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 910-918. |
[15] | 王海云, 王寅, 周信杰, 何爱群. 基于“中枢-外周-中枢”理论的经颅直流电刺激结合针刺干预脑卒中患者中枢及上肢功能的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 919-925. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||
|