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中风后渐进性抗阻训练:对肌肉力量、肌张力、步态表现和感知参与度的影响

Progressive resistance training after stroke: effects on muscle strength, muscle tone, gait performance and perceived participation.

作者信息

Flansbjer Ulla-Britt, Miller Michael, Downham David, Lexell Jan

机构信息

Department of Rehabilitation, Lund University Hospital, Lund, Sweden.

出版信息

J Rehabil Med. 2008 Jan;40(1):42-8. doi: 10.2340/16501977-0129.

Abstract

OBJECTIVE

To evaluate the effects of progressive resistance training on muscle strength, muscle tone, gait performance and perceived participation after stroke.

DESIGN

A randomized controlled trial.

SUBJECTS

Twenty-four subjects (mean age 61 years (standard deviation 5)) 6-48 months post-stroke.

METHODS

The training group (n = 15) participated in supervised progressive resistance training of the knee muscles (80% of maximum) twice weekly for 10 weeks, and the control group (n = 9) continued their usual daily activities. Both groups were assessed before and after the intervention and at follow-up after 5 months. Muscle strength was evaluated dynamically and isokinetically (60 degrees /sec) and muscle tone by the Modified Ashworth Scale. Gait performance was evaluated by Timed "Up & Go", Fast Gait Speed and 6-Minute Walk tests, and perceived participation by Stroke Impact Scale.

RESULTS

Muscle strength increased significantly after progressive resistance training with no increase in muscle tone and improvements were maintained at follow-up. Both groups improved in gait performance, but at follow-up only Timed "Up & Go" and perceived participation were significantly better for the training group.

CONCLUSIONS

Progressive resistance training is an effective intervention to improve muscle strength in chronic stroke. There appear to be long-term benefits, but further studies are needed to clarify the effects, specifically of progressive resistance training on gait performance and participation.

摘要

目的

评估渐进性抗阻训练对中风后肌肉力量、肌张力、步态表现和感知参与度的影响。

设计

一项随机对照试验。

研究对象

24名中风后6至48个月的受试者(平均年龄61岁(标准差5))。

方法

训练组(n = 15)每周两次参加膝关节肌肉的监督下渐进性抗阻训练(最大力量的80%),持续10周,对照组(n = 9)继续其日常活动。两组在干预前后以及5个月后的随访时进行评估。通过动态和等速(60度/秒)评估肌肉力量,通过改良Ashworth量表评估肌张力。通过定时起立行走测试、快速步态速度测试和6分钟步行测试评估步态表现,通过中风影响量表评估感知参与度。

结果

渐进性抗阻训练后肌肉力量显著增加,肌张力无增加,且在随访时保持改善。两组的步态表现均有所改善,但在随访时,训练组仅定时起立行走测试和感知参与度明显更好。

结论

渐进性抗阻训练是改善慢性中风肌肉力量的有效干预措施。似乎有长期益处,但需要进一步研究以明确其效果,特别是渐进性抗阻训练对步态表现和参与度的影响。

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