Locomotor Rehabilitation of Individuals With Chronic Stroke: Difference Between Responders and Nonresponders
Locomotor Rehabilitation of Individuals With Chronic Stroke: Difference Between Responders and Nonresponders
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DOI：
10.1016/j.apmr.2012.11.032
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发表时间：
2013-05-01
影响因子：
4.3
通讯作者：
Kautz, Steven A.
中科院分区：
文献类型：
--
作者：
Bowden, Mark G.;Behrman, Andrea L.;Kautz, Steven A.
目的：为了确定与改善行走速度后，在个人poststroke运动康复的临床措施，以及如何那些谁回应与临床有意义的变化，行走速度不同，从那些较小的速度increases.Design：一个单一的组前后干预研究。参与者根据步行速度变化大于（响应者）或小于（无响应者）.16 m/s进行分层。配对样本t检验用于评估各组的变化，并在每个变量的变化和步行速度的变化之间进行相关性分析。单位：门诊跨学科康复研究中心。参与者：偏瘫患者（N=27）（17例左侧轻偏瘫; 19例男性;年龄：58.74 ± 12.97岁;卒中后22.70 ± 16.38个月）。一个12-一周的运动干预，包括在跑步机上的训练，体重支持和手动训练器，伴随着地上行走训练。结局指标：运动控制，平衡，功能性步行能力和耐力的措施，收集在pre-postinterventionAssessment.Results：18响应者和9 nonresponses不同的年龄（响应者= 63.6岁，nonresponses = 49.0岁，P= 0.001）和下肢Fugl-Meyer评估评分（响应者=24.7，nonresponses =19.9，P= 0.003）。应答者的步行速度平均提高了0.27 m/s，除每日步行活动和轻瘫步行率外，所有变量均显著增加。相反，无应答者仅在步行速度和耐力方面表现出统计学显著改善。然而，步行速度增加0.10 m/s没有临床意义。步行速度的变化呈负相关，在无反应组的运动控制的变化，这意味着步行速度PHIS可能已经完成了通过补偿mechanism.Conclusions：这项研究是一个步骤识别的潜在因素有助于改善步行性能。Archives of Physical Medicine and Rehabilitation 2013;94：856-62（C）2013美国康复医学大会
Objectives: To identify the clinical measures associated with improved walking speed after locomotor rehabilitation in individuals poststroke and how those who respond with clinically meaningful changes in walking speed differ from those with smaller speed increases.Design: A single group pre-post intervention study. Participants were stratified on the basis of a walking speed change of greater than (responders) or less than (nonresponders) .16m/s. Paired sample t tests were run to assess changes in each group, and correlations were run between the change in each variable and change in walking speed.Setting: Outpatient interdisciplinary rehabilitation research center.Participants: Hemiparetic subjects (N=27) (17 left hemiparesis; 19 men; age: 58.74 +/- 12.97y; 22.70 +/- 16.38mo poststroke).Intervention: A 12-week locomotor intervention incorporating training on a treadmill with body weight support and manual trainers accompanied by training overground walking.Main Outcome Measures: Measures of motor control, balance, functional walking ability, and endurance were collected at pre- and postintervention assessments.Results: Eighteen responders and 9 nonresponders differed by age (responders=63.6y, nonresponders=49.0y, P=.001) and the lower extremity Fugl-Meyer Assessment score (responders=24.7, nonresponders=19.9, P=.003). Responders demonstrated an average improvement of .27m/s in walking speed as well as significant gains in all variables except daily step activity and paretic step ratio. Conversely, nonresponders demonstrated statistically significant improvements only in walking speed and endurance. However, the walking speed increase of .10m/s was not clinically meaningful. Change in walking speed was negatively correlated with changes in motor control in the nonresponder group, implying that walking speed phis may have been accomplished via compensatory mechanisms.Conclusions: This study is a step toward discerning the underlying factors contributing to improved walking performance. Archives of Physical Medicine and Rehabilitation 2013;94:856-62 (C) 2013 by the American Congress of Rehabilitation Medicine