Department of Physical Therapy, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
Int J Stroke. 2010 Aug;5(4):329-35. doi: 10.1111/j.1747-4949.2010.00449.x.
Gait deficits contribute considerably to functional disability after stroke, and the regaining of walking ability is a major goal in most stroke rehabilitation programmes. Evidence suggests that muscular strengthening exercises after stroke can improve strength and activity. Additionally, task-related practice performed at high intensities may enhance walking competency in people with stroke. However, there is insufficient evidence to conclude which approach is most effective.
This study will test the hypothesis that task-specific walking training plus targeted strength training is superior to task-specific walking training alone in improving strength, motor co-ordination, quality of independent walking, and participation in acute stroke patients.
This trial is a prospective, randomised clinical trial. People after stroke who are living at home and attending outpatient clinics will be randomly allocated into either an experimental or a control group. The experimental group will undertake task-specific walking training, plus targeted strength training three times per week over 10 weeks, while the control group will only undertake task-specific walking training. At baseline, after 10 weeks of intervention and 4 weeks after the cessation of the interventions, allocation-blinded researchers will collect outcome measures.
Primary outcomes will be measured for levels of impairment (strength and co-ordination), activity (quality of walking), and participation (quality of life). Secondary outcomes will be the minimal clinically important differences of lower limb strength, motor co-ordination, and gait speed.
步态缺陷是中风后导致功能障碍的主要因素，而恢复行走能力是大多数中风康复计划的主要目标。有证据表明，中风后进行肌肉强化锻炼可以增强力量和活动能力。此外，高强度的任务相关练习可能会提高中风患者的步行能力。然而，目前还没有足够的证据来确定哪种方法最有效。
本研究旨在检验以下假设，即专项步行训练加针对性力量训练优于单纯专项步行训练，能更有效地改善力量、运动协调性、独立行走质量和参与度，从而提高急性中风患者的步行能力。
这是一项前瞻性、随机临床试验。居住在家并在门诊就诊的中风后患者将被随机分配到实验组或对照组。实验组将接受每周三次、为期 10 周的专项步行训练加针对性力量训练，而对照组仅接受专项步行训练。在基线、干预 10 周后和干预停止 4 周后，盲法研究人员将收集结局测量指标。
主要结局指标将测量损伤程度（力量和协调性）、活动能力（行走质量）和参与度（生活质量）。次要结局指标将测量下肢力量、运动协调性和步态速度的最小临床重要差异。
