Optimal outcomes obtained with body-weight support combined with treadmill training in stroke subjects
Optimal outcomes obtained with body-weight support combined with treadmill training in stroke subjects
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DOI：
10.1016/s0003-9993(03)00361-7
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发表时间：
2003-10-01
影响因子：
4.3
通讯作者：
Visintin, M
中科院分区：
文献类型：
--
作者：
Barbeau, H;Visintin, M
目的：确定最有可能受益于体重支持（BWS）运动训练的卒中患者，确定从跑步机训练到地上运动的延续程度，并确定最有可能影响运动恢复的变量。设计：随机临床试验。设置：住院康复医院。参与者：在100例脑卒中患者中，50例随机接受BWS运动训练（BWS组），50例随机接受完全负重运动训练（无BWS组）。受试者根据他们的初始地上行走速度和耐力、初始跑步机速度和耐力、功能平衡、运动恢复、病变侧和年龄进行分层。50名受试者被训练在跑步机上行走，最多40%的体重由带有头顶安全带的BWS系统支撑主要结果：临床结果包括地上行走速度和耐力、功能平衡和运动恢复。混杂变量，如年龄，合并症，和抑郁症对运动outcome.Results的影响也进行了调查：经过6周的运动训练，BWS组得分显着较高的所有临床结果。当受试者根据其初始地上行走速度、耐力、平衡和运动恢复进行分层时，所有结局的步态和平衡功能障碍在受损更严重的受试者中存在显著的统计学差异。在BWS组的受试者中观察到从跑步机速度到地上行走速度的重要转移。最后，一个显着更大的影响，观察到在老年受试者（65- 85岁）在BWS group.Conclusions：在严重受损的中风受试者与他们的体重的百分比支持步态再训练导致更好的步行和姿势能力比步态训练的患者承担他们的全部重量。看起来，步态障碍较大的受试者从BWS训练中获益最多，老年中风患者也是如此。有证据表明，从跑步机训练转移到地上运动。
Objectives: To identify stroke patients who are most likely to benefit from locomotor training with body-weight support (BWS), to determine the extent of carryover from treadmill training to overground locomotion, and to determine the variables that are most likely to influence the recovery of locomotion.Design: A randomized clinical trial.Setting: Inpatient rehabilitation hospital.Participants: Of 100 stroke subjects, 50 were randomized to receive locomotor training with BWS (BWS group), and 50 were randomized to receive locomotor training with full weight bearing (no-BWS group). The subjects were stratified according to their initial overground walking speed and endurance, initial treadmill speed and endurance, functional balance, motor recovery, side of the lesion, and age.Intervention: Fifty subjects were trained to walk on a treadmill with up to 40% of their body weight supported by a BWS system with an overhead harness (BWS group), and 50 subjects were trained to walk while bearing their full weight (no-BWS group).Main Outcome Measures: Clinical outcome measures included overground walking speed and endurance, functional balance, and motor recovery. The effect of confounding variables such as age, comorbidity, and depression on locomotor outcome was also investigated.Results: After 6 weeks of locomotor training, the BWS group scored significantly higher in all clinical outcomes. When the subjects were stratified according to their initial overground walking speed, endurance, balance, and motor recovery, a significant statistical difference in gait and balance dysfunction of all outcomes occurred in the more severely impaired subjects. An important transfer from treadmill speed to overground walking speed was observed in subjects in the BWS group. Finally, a significantly greater effect was observed in older subjects (65-85y) in the BWS group.Conclusions: Retraining gait in severely impaired stroke subjects with a percentage of their body weight supported resulted in better walking and postural abilities than did gait training in patients bearing their full weight. It appears that subjects with greater gait impairments benefited the most from training with BWS, as did the older patients with stroke. There is evidence of transfer from treadmill training to overground locomotion.