Walking and balance outcomes for stroke survivors: a randomized clinical trial comparing body-weight-supported treadmill training with versus without challenging mobility skills.
Walking and balance outcomes for stroke survivors: a randomized clinical trial comparing body-weight-supported treadmill training with versus without challenging mobility skills.
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DOI：
10.1186/s12984-018-0442-3
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发表时间：
2018-11-01
影响因子：
5.1
通讯作者：
Brown DA
中科院分区：
文献类型：
--
作者：
Graham SA;Roth EJ;Brown DA
跑步机训练，有或没有体重支持（BWSTT），通常涉及高步数，更快的步行速度和更高的心率强度比地上步行训练。增加具有挑战性的移动技能练习可能会增加改善行走和平衡技能的机会。在这里，我们比较了进行BWSTT和BWSTT（包括挑战性移动技能）的慢性卒中幸存者的行走和平衡结果。一项比较两种BWSTT干预措施的单盲随机临床试验，在康复研究实验室进行，为期6周。受试者年龄18岁以上，因皮质或皮质下缺血性或出血性卒中导致慢性（≥5个月）卒中后轻偏瘫，基线时步行速度< 1.1 m/s。免提组（HF; n = 15）在没有扶手或辅助装置的帮助下进行BWSTT，而免提加挑战组（HF + C; n = 14）在额外练习挑战性移动技能的同时进行相同的方案。主要结局是舒适步行速度（CWS）的变化，次要结局是快速步行速度（FWS）、6分钟步行距离、贝格平衡量表（BBS）评分和活动特定平衡信心（ABC）评分。CWS（Z =-4.2，p ≤ 0.0001）的显著治疗前后改善，从中位数0.35 m/s（范围0.10 - 1.09）改善至中位数0.54 m/s（范围0.1 - 1.17），但未观察到组间差异（U = 96.0，p = 0.69）。所有参与者的治疗前改善导致基线救护状态从16到10个家庭救护车，3到7个有限的社区救护车和10到12个社区救护车重新分类。次要结局显示，治疗前后改善相似，组间无差异。在6周的训练后，在免提BWSTT协议中增加具有挑战性的移动技能并没有导致CWS的更大改善。缺乏组间差异的一个原因可能是，两组都在主动的、自驱动的跑步机环境中行走，而不使用扶手或辅助设备。NCT 02787759卒中后步行（FBT）的跌倒训练;回顾性注册日期为2016年6月1日。
Treadmill training, with or without body-weight support (BWSTT), typically involves high step count, faster walking speed, and higher heart-rate intensity than overground walking training. The addition of challenging mobility skill practice may offer increased opportunities to improve walking and balance skills. Here we compare walking and balance outcomes of chronic stroke survivors performing BWSTT with BWSTT including challenging mobility skills. Single-blind randomized clinical trial comparing two BWSTT interventions performed in a rehabilitation research laboratory facility over 6 weeks. Participants were 18+ years of age with chronic (≥5 months) poststroke hemiparesis due to a cortical or subcortical ischemic or hemorrhagic stroke and walking speeds < 1.1 m/s at baseline. A hands-free group (HF; n = 15) performed BWSTT without assistance from handrails or assistive devices, and a hands-free plus challenge group (HF + C; n = 14) performed the same protocol while additionally practicing challenging mobility skills. The primary outcome was change in comfortable walking speed (CWS), with secondary outcomes of fast walk speed (FWS), six-minute walk distance, Berg Balance Scale (BBS) scores, and Activities Specific Balance Confidence (ABC) scores. Significant pre-post improvement of CWS (Z = − 4.2, p ≤ 0.0001) from a median of 0.35 m/s (range 0.10 to 1.09) to a median of 0.54 m/s (range 0.1 to 1.17), but no difference observed between groups (U = 96.0, p = 0.69). Pre-post improvements across all participants resulted in reclassified baseline ambulation status from sixteen to ten household ambulators, three to seven limited community ambulators, and ten to twelve community ambulators. Secondary outcomes showed similar pre-post improvements with no between-group differences. The addition of challenging mobility skills to a hands-free BWSTT protocol did not lead to greater improvements in CWS following 6 weeks of training. One reason for lack of group differences may be that both groups were adequately challenged by walking in an active, self-driven treadmill environment without use of handrails or assistive devices. NCT02787759 Falls-based Training for Walking Post-Stroke (FBT); retrospectively registered June 1st, 2016.
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影响因子：
4.2
作者：
MacKay-Lyons, Marilyn;McDonald, Alison;Klus, Mary-Anne
通讯作者：
Klus, Mary-Anne
DOI：
10.1016/j.apmr.2004.12.026
发表时间：
2005-08-01
影响因子：
4.3
作者：
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作者：
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通讯作者：
MAURITZ, KH
影响因子：
2.1
作者：
Flansbjer, Ulla-Britt;Blom, Johanna;Brogardh, Christina
通讯作者：
Brogardh, Christina