School of Physiotherapy, Dalhousie University, Canada.
J Physiother. 2012;58(4):271. doi: 10.1016/S1836-9553(12)70131-5.
Does high-intensity aerobic treadmill exercise improve cardiovascular fitness and gait function in people with chronic stroke?
Randomised, controlled trial.
An outpatient rehabilitation centre in Germany.
Individuals with chronic stroke >60 years of age with residual gait impairment, and ability to walk on the treadmill at ≥0.3km/h for 3 minutes were eligible. Serious cardiovascular conditions (eg, angina pectoris, heart failure, valvular dysfunction, peripheral arterial occlusive disease), dementia, aphasia, and major depression were exclusion criteria. Randomisation of 38 participants allocated 20 to the intervention group and 18 to the usual care group.
The intervention group underwent treadmill training (3 times/week) for 3 months. The program was intended to achieve 30-50 minutes of treadmill training at 60-80% of the maximum heart rate reserve as determined by a maximum effort exercise test. The training was supervised by a physician and/or physiotherapist. The usual care group received conventional care physiotherapy for 1 hour 1-3 times a week without any aerobic training.
The primary outcomes were peak oxygen consumption rate and the 6-minute walk test. Secondary outcome measures were self-selected and maximum walking speeds as measured in the 10-m walk test, Berg balance score, 5-Chair-Rise test, Rivermead Mobility Index, and Medical Outcomes Study Short-Form 12 (SF- 12). The outcomes were measured at baseline, immediately after completion of training, and at 12 months.
36 participants completed the study. After the 3-month training period, the change in peak oxygen consumption rate was significantly more in the treatment group, by 6.3mL/kg/min (95% CI 5.7 to 6.9). The change in distance achieved in the 6-minute walk test was also significantly more in the treatment group by 53 metres (95% CI 32 to 75). Among the secondary outcomes, maximum walking speed (by 0.14m/s, 95% CI 0.08 to 0.20), Berg balance score (by 2.6 points, 95% CI 0.5 to 4.7), and SF-12 Mental score (by 4.0 points, 95% CI 3.4 to 4.6) improved significantly more in the treadmill training group than the usual care group after the treatment period. The groups did not differ significantly on the remaining secondary outcomes. It was reported that compared to baseline peak oxygen consumption rate and 6-minute walk test distance were significantly improved at 12 months.
A high-intensity treadmill training program improves cardiovascular fitness and gait in older adults with chronic stroke.
高强度有氧跑步机运动是否能改善慢性中风患者的心血管健康和步态功能？
随机对照试验。
德国一家门诊康复中心。
年龄在 60 岁以上，有残余步态障碍，且能在跑步机上以≥0.3km/h 的速度行走 3 分钟的慢性中风患者符合条件。有严重心血管疾病（如心绞痛、心力衰竭、瓣膜功能障碍、外周动脉闭塞性疾病）、痴呆、失语症和重度抑郁症的患者被排除在外。38 名参与者被随机分为两组，20 人分入干预组，18 人分入常规护理组。
干预组进行 3 个月的跑步机训练。该计划旨在通过最大努力运动测试确定最大心率储备的 60-80%，达到 30-50 分钟的跑步机训练。训练由医生和/或物理治疗师监督。常规护理组每周接受 1-3 次 1 小时的常规物理治疗，不进行任何有氧运动。
36 名参与者完成了研究。在 3 个月的训练期后，治疗组的峰值耗氧量增加了 6.3mL/kg/min（95%置信区间为 5.7 至 6.9），这一变化具有显著统计学意义。治疗组在 6 分钟步行测试中的距离增加也显著更多，增加了 53 米（95%置信区间为 32 至 75）。在次要结果中，最大步行速度（增加 0.14m/s，95%置信区间为 0.08 至 0.20）、Berg 平衡评分（增加 2.6 分，95%置信区间为 0.5 至 4.7）和 SF-12 精神评分（增加 4.0 分，95%置信区间为 3.4 至 4.6）在治疗后，跑步机训练组的改善程度明显大于常规护理组。两组在其余次要结果上无显著差异。据报道，与基线相比，峰值耗氧量和 6 分钟步行测试距离在 12 个月时显著提高。
高强度跑步机训练方案可改善慢性中风老年人的心血管健康和步态。
