Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study
Effects of a high-intensity task-oriented training on gait performance early after stroke: a pilot study
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DOI：
10.1177/0269215509360647
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发表时间：
2010-11-01
影响因子：
3
通讯作者：
Kwakkel, Gert
中科院分区：
文献类型：
--
作者：
Outermans, Jacqueline C.;van Peppen, Roland P. S.;Kwakkel, Gert
目的：探讨与低强度物理治疗方案相比，亚急性中风患者进行高强度任务导向训练（包括高心血管负荷和大量重复）的可行性及其对步态的影响。设计和受试者：随机对照临床试验：在中风发作后 2 至 8 周招募 44 名中风患者。测量：通过 10 米定时步行测试 (10MTWT) 评估最大步态速度，步行能力通过六分钟步行测试（6MWT）进行评估。通过 Berg 平衡量表和功能伸展测试评估站立平衡的控制。使用曼-惠特尼 U 检验分析组间差异。结果：组间分析显示，在 10MTWT（Z = -2.13，P = 0.03）和 6MWT（Z = -2.26，P = 0.02）的表现上，组间分析显示有利于高强度任务导向训练的统计显着差异。 Berg平衡量表（Z = -0.07，P = 0.45）和功能伸展测试（Z = -0.21，P = 0.84）没有发现组间差异。结论：旨在改善偏瘫步态和身体素质的高强度任务导向训练计划在本研究中是可行的，并且在步态速度和步行能力方面，其有效性超过了低强度物理治疗计划。亚急性中风。在未来的研究中，额外使用措施来评估步行时的身体健康和能量消耗似乎是合适的。
Objective: To investigate the feasibility and the effects on gait of a high intensity task-oriented training, incorporating a high cardiovascular workload and large number of repetitions, in patients with subacute stroke, when compared to a low intensity physiotherapy-programme.Design and subjects: Randomized controlled clinical trial: Forty-four patients with stroke were recruited at 2 to 8 weeks after stroke onset.Measures: Maximal gait speed assessed with the 10-metre timed walking test (10MTWT), walking capacity assessed with the six-minute walk test (6MWT). Control of standing balance assessed with the Berg Balance Scale and the Functional Reach test. Group differences were analysed using a Mann-Whitney U-test.Results: Between-group analysis showed a statistically significant difference in favour of the high intensity task-oriented training in performance on the 10MTWT (Z = -2.13, P = 0.03) and the 6MWT (Z = -2.26, P = 0.02). No between-group difference were found for the Berg Balance Scale (Z = -0.07, P = 0.45) and the Functional Reach test (Z = -0.21, P = 0.84).Conclusion: A high-intensity task-oriented training programme designed to improve hemiplegic gait and physical fitness was feasible in the present study and the effectiveness exceeds a low intensity physiotherapy-programme in terms of gait speed and walking capacity in patients with subacute stroke. In a future study, it seems appropriate to additionally use measures to evaluate physical fitness and energy expenditure while walking.