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平衡、平衡信心和慢性中风患者在身体重量支持跑步机训练后的与健康相关的生活质量。

Balance, balance confidence, and health-related quality of life in persons with chronic stroke after body weight-supported treadmill training.

机构信息

University of Indianapolis, IN, USA.

出版信息

Arch Phys Med Rehabil. 2010 Dec;91(12):1914-9. doi: 10.1016/j.apmr.2010.08.025.

Abstract

OBJECTIVES

To examine changes in balance, balance confidence, and health-related quality of life immediately and 6 months after body weight-supported treadmill training (BWSTT) for persons with chronic stroke (primary objective) and to determine whether changes in gait speed after BWSTT were associated with changes in these dimensions of health (secondary objective).

DESIGN

Prospective pre-/posttest pilot study with 6 months retention.

SETTING

University research laboratory settings.

PARTICIPANTS

A convenience sample of participants (N=19; at least 6mo poststroke; able to ambulate 0.4-0.8m/s) were recruited.

INTERVENTION

BWSTT was provided for 24 sessions over 8 weeks with 20 minutes of total walking each session.

MAIN OUTCOME MEASURES

Berg Balance Scale (BBS), Activities-Specific Balance Confidence (ABC) Scale, Stroke Impact Scale (SIS), comfortable 10-m walk test (CWT), and fast 10-m walk test (FWT). Proportions of participants who achieved minimal detectable changes (MDCs) were examined for all measures.

RESULTS

Statistically significant improvements were found from pre- to posttest for BBS, ABC, SIS mobility, SIS stroke recovery, and CWT scores (P<.05) and from pretest to retention on BBS, ABC, CWT, and FWT scores (P<.05). For most participants, improvements did not exceed MDCs. Changes in gait speed and BBS, ABC, and SIS scores were not associated.

CONCLUSIONS

The findings of this study suggest that effects of BWSTT may transfer beyond gait to positively influence balance, balance confidence, and health-related quality of life. However, for most participants, BWSTT was not sufficient to induce improvements in balance and balance confidence beyond measurement error or long-term retention of enhanced perceptions of quality of life.

摘要

目的

检测慢性脑卒中患者接受减重支持跑台训练(BWSTT)后即刻和 6 个月时平衡、平衡信心和健康相关生活质量的变化(主要目标),并确定 BWSTT 后步态速度的变化是否与这些健康维度的变化相关(次要目标)。

设计

前瞻性预/后测试试点研究,保留期为 6 个月。

地点

大学研究实验室。

参与者

招募了一组方便的参与者样本(N=19;至少脑卒中后 6 个月;能够以 0.4-0.8m/s 的速度行走)。

干预措施

BWSTT 在 8 周内提供 24 次治疗,每次治疗总步行时间为 20 分钟。

主要观察指标

伯格平衡量表(BBS)、活动特定平衡信心量表(ABC)、脑卒中影响量表(SIS)、舒适 10 米步行测试(CWT)和快速 10 米步行测试(FWT)。所有测量值均检查了达到最小可检测变化(MDC)的参与者比例。

结果

与预测试相比,BBS、ABC、SIS 运动、SIS 脑卒中康复和 CWT 得分在测试后均有统计学意义的提高(P<.05),BBS、ABC、CWT 和 FWT 得分在预测试到保留期之间也有统计学意义的提高(P<.05)。对于大多数参与者,改善程度未超过 MDC。步态速度变化与 BBS、ABC 和 SIS 评分无相关性。

结论

本研究结果表明,BWSTT 的效果可能不仅限于步态,还能积极影响平衡、平衡信心和健康相关生活质量。然而,对于大多数参与者,BWSTT 不足以在测量误差或长期保留生活质量增强感知的基础上,改善平衡和平衡信心。

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