Department of Physical Therapy, Faculty of Health Science, Kio University, Nara, Japan.
Top Stroke Rehabil. 2012 Sep-Oct;19(5):377-83. doi: 10.1310/tsr1905-377.
Atherothrombosis due to arteriosclerosis is a risk factor for recurrence of stroke. Although exercise therapy is essential to prevent progression of arteriosclerosis and to improve endothelial function, little is known about the effect of rehabilitation in chronic stroke survivors.
The purpose of this study was to investigate the effect of intensive rehabilitation on physical and arterial function among community-dwelling stroke survivors.
Forty-four community-dwelling stroke survivors participated in the study. The experimental group (n = 22) received primarily intensive strengthening exercise and the control group (n = 22) received standard physical therapy consisting mainly of stretching and gait training. Both groups underwent the rehabilitation program for 12 weeks. Physical function was evaluated using 10-m gait velocity, the 30-s chair stand test, Timed Up and Go test, and grip strength. Arterial function of the affected and unaffected sides was evaluated using the cardio-ankle vascular index (CAVI) as an index of arterial stiffness and the ankle-brachial pressure index (ABI) as an index of arterial occlusion.
After the 12-week rehabilitation period, improvement in physical function did not differ between the 2 groups; whereas with regard to arterial function, a significant improvement in the CAVI for the affected side was observed in the experimental group (P < .001). Also, the ABI for the unaffected side in the experimental group was significantly improved after intervention (P < .001). No significant differences were found for the unaffected-side CAVI and affected-side ABI between the 2 groups.
These findings suggested that intensive rehabilitation for stroke patients during the chronic stage preserved physical function and improved arterial function.
动脉粥样硬化引起的动脉血栓形成是中风复发的一个危险因素。尽管运动疗法对于预防动脉硬化进展和改善内皮功能至关重要,但对于慢性中风幸存者的康复效果知之甚少。
本研究旨在探讨强化康复对社区居住的中风幸存者身体和动脉功能的影响。
44 名社区居住的中风幸存者参加了这项研究。实验组(n=22)接受主要的强化力量训练,对照组(n=22)接受主要包括伸展和步态训练的标准物理治疗。两组均接受 12 周的康复计划。使用 10 米步行速度、30 秒坐站测试、计时起立行走测试和握力评估身体功能。使用心血管踝血管指数(CAVI)作为动脉僵硬的指标和踝臂血压指数(ABI)作为动脉阻塞的指标评估受影响和未受影响侧的动脉功能。
在 12 周的康复期后,两组的身体功能改善没有差异;然而,就动脉功能而言,实验组受影响侧的 CAVI 显著改善(P<0.001)。此外,实验组未受影响侧的 ABI 在干预后也显著改善(P<0.001)。两组之间未受影响侧的 CAVI 和受影响侧的 ABI 没有显著差异。
这些发现表明,慢性期中风患者的强化康复可以保持身体功能并改善动脉功能。