Brooks Dina, Tang Ada, Sibley Kathryn M, McIlroy William E
Dina Brooks, PhD: Associate Professor, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario.
Physiother Can. 2008 Spring;60(2):171-9. doi: 10.3138/physio.60.2.171. Epub 2008 Oct 10.
The purposes of this study were to characterize the cardiorespiratory capacity of individuals on admission to inpatient rehabilitation following stroke and to examine the relationship between measures of cardiorespiratory capacity and standard indices of neurological deficit and functional status.
We recruited 45 patients within the first 10 days of admission to rehabilitation. We performed measures of aerobic fitness (VO(2)peak), functional status (Functional Independence Measure [FIM] and Clinical Outcomes Variable Score [COVS]), and neurological deficit (National Institutes of Health Stroke Scale [NIHSS] and Chedoke-McMaster Stroke Assessment scale [CMSA]).
Nineteen women and 26 men with a mean (SD) age of 65.2 (14.5) years were admitted to rehabilitation 16.2 (11.9) (minimum 3, maximum 62) days post-stroke. Average VO(2)peak was less than half the value expected in age-matched healthy individuals at 11.1 (3.1) ml/kg/min. The associations between VO(2)peak and FIM, NIHSS, and COVS were weak (r = 0.25, -0.12, and 0.26 respectively, p = 0.12, 0.46, and 0.10 respectively). There were no differences in VO(2)peak in higher-functioning individuals with CMSA leg scores of 5 and 6 compared to lower-functioning individuals with scores of 3 and 4 (p = 0.30).
Cardiorespiratory capacity is extremely low in individuals during the first 3 months after stroke. Alternative measures of functional or clinical status do not adequately reflect this cardiorespiratory state; thus, routine measurement of cardiorespiratory capacity should be considered, along with a risk-factor profile.
本研究的目的是描述中风后住院康复患者入院时的心肺功能，并探讨心肺功能测量值与神经功能缺损和功能状态标准指标之间的关系。
我们在康复入院的前10天内招募了45名患者。我们进行了有氧适能（VO₂峰值）、功能状态（功能独立性测量[FIM]和临床结果变量评分[COVS]）以及神经功能缺损（美国国立卫生研究院卒中量表[NIHSS]和切多克-麦克马斯特卒中评估量表[CMSA]）的测量。
19名女性和26名男性，平均（标准差）年龄为65.2（14.5）岁，在中风后16.2（11.9）天（最短3天，最长62天）入院接受康复治疗。平均VO₂峰值为11.1（3.1）毫升/千克/分钟，不到年龄匹配的健康个体预期值的一半。VO₂峰值与FIM、NIHSS和COVS之间的关联较弱（r分别为0.25、-0.12和0.26，p分别为0.12、0.46和0.10）。与CMSA腿部评分为3分和4分的功能较低的个体相比，CMSA腿部评分为5分和6分的功能较高的个体在VO₂峰值方面没有差异（p = 0.30）。
中风后前3个月患者的心肺功能极低。功能或临床状态的替代测量方法不能充分反映这种心肺状态；因此，应考虑常规测量心肺功能以及风险因素概况。
