Stepwise Regression and Latent Profile Analyses of Locomotor Outcomes Poststroke.
Stepwise Regression and Latent Profile Analyses of Locomotor Outcomes Poststroke.
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DOI：
10.1161/strokeaha.120.031065
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发表时间：
2020-10
期刊：
影响因子：
8.3
通讯作者：
Jang JH
中科院分区：
文献类型：
--
作者：
Hornby TG;Henderson CE;Holleran CL;Lovell L;Roth EJ;Jang JH
先前的数据表明，患者的人口统计学和临床表现是卒中后运动恢复的主要预测因素，物理干预的贡献最小。其他研究表明，踏步练习的数量和强度与运动结果之间存在一致的关联。本研究的目的是确定这些组合变量对卒中后运动结果的相对贡献，包括一系列患者人口统计学和基线功能。数据来自3项独立的试验，这些试验评估了高强度训练（HIT）、低强度训练和常规干预的有效性。144名卒中后> 1个月的参与者的人口统计学、临床特征和训练活动被纳入逐步回归分析，以确定他们对运动结果的相对贡献。随后的潜在特征分析根据参与者对干预措施的反应评估了参与者类别的差异。逐步回归分析表明，步行活动对运动结果的主要贡献，以及年龄、卒中后持续时间和基线功能的额外影响。潜在的个人资料分析揭示了2个主要类别的结果，最大的收益在那些谁收到HIT和实现了最大量的踏步练习。回归和潜在的配置文件分析表明，只有HIT参与者的年龄，基线功能和训练活动的主要决定因素的运动收益。具有最小增益的参与者年龄较大（约60岁），步态速度较慢（<0.40 m/s），并且每节课少走600-1000步。回归和聚类分析揭示了训练干预对卒中后> 1个月患者活动性结局的主要贡献。年龄、卒中后病程和基线损伤是次要预测因素。https://clinicaltrials.gov/.唯一标识符：NCT 02507466和NCT 01789853
Previous data suggest patient demographics and clinical presentation are primary predictors of motor recovery post-stroke, with minimal contributions of physical interventions. Other studies indicate consistent associations between the amount and intensity of stepping practice with locomotor outcomes. The goal of this study was to determine the relative contributions of these combined variables to locomotor outcomes post-stroke across a range of patient demographics and baseline function. Data were pooled from 3 separate trials evaluating the efficacy of high-intensity training (HIT), low-intensity training, and conventional interventions. Demographics, clinical characteristics and training activities from 144 participants > 1-month post-stroke were included in stepwise regression analyses to determine their relative contributions to locomotor outcomes. Subsequent latent profile analyses evaluated differences in classes of participants based on their responses to interventions. Stepwise regressions indicate primary contributions of stepping activity on locomotor outcomes, with additional influences of age, duration post-stroke, and baseline function. Latent profile analyses revealed 2 main classes of outcomes, with the largest gains in those who received HIT and achieved the greatest amounts of stepping practice. Regression and latent profile analyses of only HIT participants indicated age, baseline function and training activities were primary determinants of locomotor gains. Participants with the smallest gains were older (~60 years), presented with slower gait speeds (<0.40 m/s) and performed 600-1000 less steps/session. Regression and cluster analyses reveal primary contributions of training interventions on mobility outcomes in patients > 1-month post-stroke. Age, duration post-stroke and baseline impairments were secondary predictors. https://clinicaltrials.gov/. Unique Identifiers: NCT02507466 and NCT01789853