Effect of duration of upper- and lower-extremity rehabilitation sessions and walking speed on recovery of interlimb coordination in hemiplegic gait
Effect of duration of upper- and lower-extremity rehabilitation sessions and walking speed on recovery of interlimb coordination in hemiplegic gait
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DOI：
10.1093/ptj/82.5.432
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发表时间：
2002-05-01
期刊：
影响因子：
3.2
通讯作者：
Wagenaar, RC
中科院分区：
文献类型：
--
作者：
Kwakkel, G;Wagenaar, RC
背景和目的。研究了不同时间的上肢和下肢康复训练对脑卒中患者偏瘫步态肢体间协调功能恢复的影响。主题和方法。53名患有累及大脑中动脉的中风的受试者被分配到康复计划中，（1）重点是LE，（2）重点是麻痹UE，或（3）用充气压力夹板固定麻痹手臂（UE）和腿部（LE）（对照治疗）。在中风发作后的前20周内，每周5天，每周30分钟应用3种治疗方案。VI受试者还参加了每周5天的康复计划，除了每周11/2小时的日常生活活动训练外，还包括15分钟的UE锻炼和15分钟的LE锻炼。采用重复测量设计。在舒适和最大步行速度方面评价了3种治疗方案之间的差异。此外，平均连续相对相位（CRP）之间的麻痹性手臂和腿部（PAL）的运动和非麻痹性手臂和腿部（NAL）的运动和标准差的CRP的两个肢体对作为稳定性（变异性）的测量进行了评价。结果与接受涉及UE的干预的组和接受对照治疗的组相比，接受涉及LE的干预的组的舒适步行速度有所改善。NAL和PAL的平均CRP以及两个肢体对的CRP标准差在3种治疗条件之间没有差异。讨论和结论。除了由于康复疗程持续时间较长而导致舒适步行速度提高外，LE和UE的康复疗程持续时间对我们测量的与偏瘫步态相关的变量没有不同的影响。然而，增加步行速度导致两个肢体对的平均CRP更大，步行的稳定性和不对称性增加，表明行走速度影响偏瘫步态中的肢体间协调。
Background and Purpose. The effects of different durations of rehabilitation sessions for the upper extremities (UEs) and lower extremities (LEs) on the recovery of interlimb coordination in hemiplegic gait in patients who have had a stroke were investigated. Subjects and Methods. Fifty-three Subjects who had strokes involving their middle cerebral arteries were assigned to rehabilitation programs with (1) an emphasis on the LEs, (2) an emphasis on the paretic UE, or (3) a condition in which the paretic arm (UE) and leg (LE) were immobilized with an inflatable pressure splint (control treatment). The 3 treatment regimens were applied for 30 minutes, 5 days a week, during the first 20 weeks after onset of stroke. VI Subjects also participated in a rehabilitation program 5 days a week that consisted of 15 minutes of UE exercises and 15 minutes of LE exercises in addition to a weekly 11/2-hour session of training in activities of daily living. A repeated-measures design was used. Differences among the 3 treatment regimens were evaluated in terms of comfortable and maximal walking speeds. In addition, mean continuous relative phase (CRP) between paretic arm and leg (PAL) movements and nonparetic arm and leg (NAL) movements and standard deviations of CRP of both limb pairs as a measurement of stability (variability) were evaluated. Results. Comfortable walking speed improved in the group that received interventions involving the LEs compared with the group that received interventions involving the UEs and the group that received the control treatment. No differences among the 3 treatment conditions were found for the mean CRP of NAL and PAL as well as the standard deviation of CRP of both limb pairs. Discussion and Conclusion. With the exception of an improved comfortable walking speed as a result of a longer duration of rehabilitation sessions, no differential effects of duration of rehabilitation sessions for the LEs and UEs on the variable we measured related to hemiplegic gait were found. Increasing walking speed, however, resulted in a larger mean CRP for both limb pairs, with increased stability and asymmetry of walking, indicating that walking speed influences interlimb coordination in hemiplegic gait.