Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
Arch Phys Med Rehabil. 2012 Apr;93(4):669-76. doi: 10.1016/j.apmr.2011.09.022. Epub 2012 Feb 13.
To examine changes in cardiorespiratory fitness over the first year poststroke and explore the effect of prestroke patients' characteristics and stroke-related factors on this evolution.
Descriptive, longitudinal study with repeated measures of exercise capacity at 3, 6, and 12 months poststroke.
Rehabilitation center and exercise testing laboratory.
Consecutive sample of patients with stroke (N=33; mean age ± SD, 59.0±11.3 y).
Not applicable.
Peak oxygen consumption (VO(2)peak) and oxygen uptake efficiency slope (OUES) were determined during a symptom-limited graded cycle ergometer test at 3, 6, and 12 months poststroke. Age, sex, premorbid physical activity level, clinical history (smoking, diabetes mellitus, chronic pulmonary diseases, cardiovascular diseases, overweight, and hypertension), stroke type and area, side of lesion, and assessments of stroke severity were evaluated at intake.
Mean VO(2)peak ± SD was 18.1±6.6 mL·kg(-1)·min(-1), 19.8±8.0 mL·kg(-1)·min(-1), and 19.7±8.4 mL·kg(-1)·min(-1) at 3, 6, and 12 months poststroke. Values for OUES were 1575.3±638.3, 1710.7±710.3, and 1687.2±777.5, respectively. Mixed models showed no significant difference over time for VO(2)peak (P=.10), nor for the logarithm of OUES (P=.09). Stroke survivors at risk of deconditioning were premorbidly less active at work or in sport activities, diabetic, or initially more severely impaired. Combination of factors revealed that older patients with stroke and diabetes were less likely to improve on VO(2)peak and that older, women, diabetic nonsmokers improved less on log OUES.
Cardiorespiratory fitness was reduced from 3 to 12 months poststroke and on average did not significantly change over time. Further studies should elucidate methods of increasing cardiorespiratory fitness during stay in the rehabilitation center and how community-based aerobic exercise training postrehabilitation can be organized.
观察脑卒中后第一年心肺功能的变化，并探讨患者发病前的特征和与脑卒中相关的因素对这一演变的影响。
描述性、纵向研究，对脑卒中后 3、6 和 12 个月的运动能力进行重复测量。
康复中心和运动测试实验室。
连续样本的脑卒中患者（N=33；平均年龄±标准差，59.0±11.3 岁）。
不适用。
在脑卒中后 3、6 和 12 个月进行症状限制分级踏车运动试验时，测定峰值氧耗量（VO2peak）和摄氧量效率斜率（OUES）。在入组时评估年龄、性别、发病前体力活动水平、临床病史（吸烟、糖尿病、慢性肺部疾病、心血管疾病、超重和高血压）、脑卒中类型和部位、病变侧及脑卒中严重程度的评估。
平均 VO2peak±标准差分别为脑卒中后 3、6 和 12 个月时的 18.1±6.6 mL·kg-1·min-1、19.8±8.0 mL·kg-1·min-1 和 19.7±8.4 mL·kg-1·min-1。OUES 值分别为 1575.3±638.3、1710.7±710.3 和 1687.2±777.5。混合模型显示，VO2peak 随时间无显著差异（P=.10），对数 OUES 也无显著差异（P=.09）。有失健风险的脑卒中幸存者在工作或运动活动中发病前的活动量较少，患有糖尿病，或最初的损伤程度更严重。多种因素的结合表明，年龄较大、患有糖尿病的脑卒中患者 VO2peak 改善的可能性较小，而年龄较大、女性、非吸烟的糖尿病患者 log OUES 的改善程度较小。
脑卒中后 3 至 12 个月心肺功能下降，平均随时间无明显变化。进一步的研究应该阐明在康复中心增加心肺功能的方法，以及如何组织康复后社区有氧运动训练。
