Nascimento Lucas R, Caetano Lívia C G, Freitas Daniele C M A, Morais Tatiane M, Polese Janaine C, Teixeira-Salmela Luci F
Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Rev Bras Fisioter. 2012 Apr;16(2):122-7. doi: 10.1590/s1413-35552012005000008. Epub 2012 Mar 1.
To evaluate the effects of different instructions for the assessment of maximum walking speed during the ten-meter walking test with chronic stroke subjects.
Participants were instructed to walk under four experimental conditions: (1) comfortable speed, (2) maximum speed (simple verbal command), (3) maximum speed (modified verbal command--"catch a bus") and (4) maximum speed (verbal command + demonstration). Participants walked three times in each condition and the mean time to cover the intermediate 10 meters of a 14-meter corridor was registered to calculate the gait speed (m/s). Repeated-measures ANOVAs, followed by planned contrasts, were employed to investigate differences between the conditions (α=5%). Means, standard deviations and 95% confidence intervals (CI) were calculated.
The mean values for the four conditions were: (1) 0.74m/s; (2) 0.85 m/s; (3) 0.93 m/s; (4) 0.92 m/s, respectively, with significant differences between the conditions (F=40.9; p<0.001). Comfortable speed was significantly slower than the maximum speed, indicating that the participants were able to increase speeds when required. Significant differences were observed between the second condition with the third (p=0.002; 95%CI=-0.13 to -0.03) and the fourth conditions (p=0.004; 95%CI=-0.12 to -0.02) with no differences between the third and fourth conditions (p=1.00; 95%CI=-0.04 to 0.05).
The results indicated that simple verbal commands were not sufficient to capture maximum gait speed with chronic stroke subjects. Thus, for clinical assessments and research purposes, where measurements of the maximum gait speed are necessary, modified verbal commands or demonstration strategies could be employed by physical therapists to ensure accurate information.
评估不同指导方式对慢性卒中患者十米步行测试中最大步行速度评估的影响。
参与者在四种实验条件下行走:(1)舒适速度;(2)最大速度(简单口头指令);(3)最大速度(改良口头指令——“赶公交车”);(4)最大速度(口头指令+示范)。参与者在每种条件下行走三次,记录走完14米走廊中间10米的平均时间,以计算步态速度(米/秒)。采用重复测量方差分析,随后进行计划对比,以研究不同条件之间的差异(α=5%)。计算均值、标准差和95%置信区间(CI)。
四种条件下的均值分别为:(1)0.74米/秒;(2)0.85米/秒;(3)0.93米/秒;(4)0.92米/秒,不同条件之间存在显著差异(F=40.9;p<0.001)。舒适速度明显慢于最大速度,表明参与者能够在需要时提高速度。在第二种条件与第三种条件(p=0.002;95%CI=-0.13至-0.03)和第四种条件之间观察到显著差异(p=0.004;95%CI=-0.12至-0.02),而第三种和第四种条件之间没有差异(p=1.00;95%CI=-0.04至0.05)。
结果表明,简单口头指令不足以获取慢性卒中患者的最大步态速度。因此,对于临床评估和研究目的,在需要测量最大步态速度时,物理治疗师可采用改良口头指令或示范策略以确保获得准确信息。