Geffen School of Medicine, University of California Los Angeles, Los Angeles, California 90095, USA.
Neurorehabil Neural Repair. 2010 Mar-Apr;24(3):235-42. doi: 10.1177/1545968309357558.
Feedback about performance may optimize motor relearning after stroke.
Develop an international collaboration to rapidly test the potential efficacy of daily verbal feedback about walking speed during inpatient rehabilitation after stroke, using a protocol that requires no research funds.
This phase 2, single-blinded, multicenter trial randomized inpatients to either feedback about self-selected fast walking speed (daily reinforcement of speed, DRS) immediately after a single, daily 10-m walk or to no reinforcement of speed (NRS) after the walk, performed within the context of routine physical therapy. The primary outcome was velocity for a 15.2-m (50-foot) timed walk at discharge. Secondary outcomes were walking distance in 3 minutes, length of stay (LOS), and level of independence (Functional Ambulation Classification, FAC).
Within 18 months, 179 participants were randomized. The groups were balanced for age, gender, time from onset of stroke to entry, initial velocity, and level of walking-related disability. The walking speed at discharge for DRS (0.91 m/s) was greater (P = .01) than that for NRS (0.72 m/s). No difference was found for LOS. LOS for both DRS and NRS was significantly shorter, however, for those who had mean walking speeds >0.4 m/s at entry. The DRS group did not have a higher proportion of FAC independent walkers (P = .1) and did not walk longer distances ( P = .09).
An Internet-based collaboration of 18 centers found that feedback about performance once a day produced gains in walking speed large enough to permit unlimited, slow community ambulation at discharge from inpatient rehabilitation.
关于表现的反馈可能会优化中风后的运动再学习。
建立一个国际合作组织，迅速测试在中风后住院康复期间每天口头反馈行走速度的潜在效果，该协议不需要研究资金。
这是一项 2 期、单盲、多中心试验，将住院患者随机分为两组，一组在每日 10 米步行后立即接受关于自我选择快走速度的反馈（每日速度强化，DRS），另一组在常规物理治疗中不强化速度（NRS）。主要结局是出院时 15.2 米（50 英尺）计时步行的速度。次要结局是 3 分钟的步行距离、住院时间（LOS）和独立性水平（功能性步行分类，FAC）。
在 18 个月内，179 名参与者被随机分组。两组在年龄、性别、从中风发作到入院的时间、初始速度和与步行相关的残疾程度方面均平衡。DRS 组的出院时行走速度（0.91m/s）大于 NRS 组（0.72m/s）（P=0.01）。但 LOS 无差异。然而，对于那些入院时平均行走速度大于 0.4m/s 的患者，DRS 和 NRS 的 LOS 都明显缩短。DRS 组独立行走者的比例（FAC）没有更高（P=0.1），行走距离也没有更长（P=0.09）。
由 18 个中心组成的基于互联网的合作发现，每天一次的表现反馈可使行走速度显著提高，从而允许中风后住院康复患者出院后在社区内无限慢速行走。
