Dual Effects of Body-Weight Supported Treadmill Training on Cardiovascular Fitness and Walking Ability Early After Stroke: A Randomized Controlled Trial
Dual Effects of Body-Weight Supported Treadmill Training on Cardiovascular Fitness and Walking Ability Early After Stroke: A Randomized Controlled Trial
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DOI：
10.1177/1545968313484809
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发表时间：
2013-09-01
影响因子：
4.2
通讯作者：
Klus, Mary-Anne
中科院分区：
文献类型：
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作者：
MacKay-Lyons, Marilyn;McDonald, Alison;Klus, Mary-Anne
背景体重支持跑步机训练（BWSTT），以训练健身和americans尚未进行调查。Objective.比较BWSTT与剂量等效的常规护理（UC）在改善卒中后早期心血管健康和步行方面的有效性。方法.参与者被随机分配到2种干预措施之一：BWSTT + UC或UC。所有人都参加了60分钟的物理治疗课程，每周5次，作为住院患者，为期6周，每周3次，作为门诊患者，为期6周。基线、训练后、6个月和12个月随访结局指标如下：主要，体能（峰值耗氧量，VO 2峰值）和步行能力（6分钟步行试验[6 MWT]和10米步行）;次要，贝格平衡量表（BBS）和运动障碍（Chedoke-McMaster腿部和足部恢复阶段[CMSR]）。结果总共有50名受试者（平均年龄60 ± 14岁;平均事件至随机化时间23 ± 5天; 29名男性）参与研究。未发生不良事件。BWSTT使VO 2峰值改善了30%，显著大于UC观察到的8%改善（两组间P = 0.004）。同样，对于6 MWT和CMSR足，存在显著的时间x组相互作用，BWSTT在距离（P = 0.15;分别为48%和19%）和分期（P = 0.01;分别为1.0和0.3）方面优于UC。在10米步行速度、BBS或CMSR腿方面没有观察到组效应，两组均表现出显著的增益。一般而言，观察到的收益可保持12个月。结论.在亚急性卒中后阶段，BWSTT比UC更能改善心血管健康和步行耐力。这些收益基本上可以维持一年。
Background. Body-weight-supported treadmill training (BWSTT) to train both fitness and ambulation has not been investigated. Objective. To compare the effectiveness of BWSTT to dose-equivalent usual care (UC) in improving cardiovascular fitness and walking early after stroke. Methods. Participants were randomly assigned to 1 of 2 interventions: BWSTT + UC or UC. All individuals participated in 60-minute physiotherapy sessions 5 times weekly as inpatients for 6 weeks and 3 times weekly as outpatients for another 6 weeks. Baseline, posttraining, 6-, and 12-month follow-up outcome measures were as follows: primary, fitness (peak oxygen consumption, VO2peak) and walking ability (6-Minute Walk Test [6MWT] and 10-m walk); secondary, Berg Balance Scale (BBS) and motor impairment (Chedoke-McMaster Stages of Recovery [CMSR] Leg and Foot). Results. In all, 50 individuals (mean age, 60 +/- 14 years; mean event-to-randomization, 23 +/- 5 days; 29 men) participated. No adverse events occurred. BWSTT improved VO2peak by 30%, which was significantly greater than the 8% improvement observed for UC (P = .004 between groups). Similarly, there were significant Time x Group interactions for 6MWT and CMSR Foot, with BWSTT outperforming UC for gains in distance (P = .15; 48% vs 19%, respectively) and stage (P = .01; 1.0 vs 0.3, respectively). No group effect was seen for 10-m walk speed, BBS, or CMSR Leg, with both groups demonstrating significant gains. In general, gains observed were preserved for 12 months. Conclusions. BWSTT elicits greater improvements in cardiovascular fitness and walking endurance than UC in the subacute poststroke period. These gains are largely sustained for 1 year.