Chronic Stroke Survivors Benefit From High-Intensity Aerobic Treadmill Exercise: A Randomized Control Trial
Chronic Stroke Survivors Benefit From High-Intensity Aerobic Treadmill Exercise: A Randomized Control Trial
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DOI：
10.1177/1545968311418675
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发表时间：
2012-01-01
影响因子：
4.2
通讯作者：
Luft, Andreas R.
中科院分区：
文献类型：
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作者：
Globas, Christoph;Becker, Clemens;Luft, Andreas R.
背景和目的。中风后活动的受试者可能受益于以步态为导向的心血管健身训练，但迄今为止的试验尚未主要评估老年人。方法。在中风6个月后，38名伴有残余偏瘫步态的受试者（年龄50 - 60岁）被纳入研究。参与者随机接受3个月（3次/周）渐进式分级、高强度有氧跑步机运动（TAEX）或常规护理物理治疗。主要结局指标是峰值运动能力（Vo(2peak)）和6分钟步行的持续步行能力（6MW）。次要测量是10米步行时的步态速度、Berg平衡量表、腿部功能力量（5椅子上升）、自评活动能力（Rivermead活动能力指数）和生活质量（SF-12）。结果。36名参与者完成了研究（18名TAEX， 18名对照组）。TAEX与常规护理相比可改善Vo（2峰）（差异6.4 mL/kg/min, P < 0.001）和6MW （53 m, P < 0.001）。同样，TAEX后最大步行速度（0.13 m/s, P = 0.01）、平衡能力（P < 0.05）和SF-12心理评分（P < 0.01）均有显著改善。Vo（2peak）的增加与个体参与者的训练强度可以增加的程度相关（P < 0.01）。更好的步行与跑步机速度和训练时间的进展有关（P < 0.001）。训练结束1年后，Vo（2peak）和6MW的表现仍高于基线，但耐力步行（6MW）在1年后低于训练后立即（P < 0.01）。结论。本试验表明TAEX能有效改善慢性脑卒中患者的心血管健康和步态。
Background and objective. Ambulatory subjects after stroke may benefit from gait-oriented cardiovascular fitness training, but trials to date have not primarily assessed older persons. Methods. Thirty-eight subjects (age > 60 years) with residual hemiparetic gait were enrolled > 6 months after stroke. Participants were randomized to receive 3 months (3x/week) progressive graded, high-intensity aerobic treadmill exercise (TAEX) or conventional care physiotherapy. Primary outcome measures were peak exercise capacity (Vo(2peak)) and sustained walking capacity in 6-minute walks (6MW). Secondary measures were gait velocity in 10-m walks, Berg Balance Scale, functional leg strength (5 chair-rise), self-rated mobility (Rivermead Mobility Index), and quality of life (SF-12). Results. Thirty-six participants completed the study (18 TAEX, 18 controls). TAEX but not conventional care improved Vo(2peak) (difference 6.4 mL/kg/min, P < .001) and 6MW (53 m, P < .001). Likewise, maximum walking speed (0.13 m/s, P = .01), balance (P < .05), and the mental subscore of the SF-12 (P < .01) improved more after TAEX. Gains in Vo(2peak) correlated with the degree at which training intensity could be progressed in the individual participant (P < .01). Better walking was related to progression in treadmill velocity and training duration (P < .001). Vo(2peak) and 6MW performances were still higher 1 year after the end of training when compared with the baseline, although endurance walking (6MW) at 1 year was lower than immediately after training (P < .01). Conclusion. This trial demonstrates that TAEX effectively improves cardiovascular fitness and gait in persons with chronic stroke.