School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.
Neurorehabil Neural Repair. 2013 Sep;27(7):644-53. doi: 10.1177/1545968313484809. Epub 2013 Apr 18.
Body-weight-supported treadmill training (BWSTT) to train both fitness and ambulation has not been investigated.
To compare the effectiveness of BWSTT to dose-equivalent usual care (UC) in improving cardiovascular fitness and walking early after stroke.
Participants were randomly assigned to 1 of 2 interventions: BWSTT + UC or UC. All individuals participated in 60-minute physiotherapy sessions 5 times weekly as inpatients for 6 weeks and 3 times weekly as outpatients for another 6 weeks. Baseline, posttraining, 6-, and 12-month follow-up outcome measures were as follows: primary, fitness (peak oxygen consumption, VO2peak) and walking ability (6-Minute Walk Test [6MWT] and 10-m walk); secondary, Berg Balance Scale (BBS) and motor impairment (Chedoke-McMaster Stages of Recovery [CMSR] Leg and Foot).
In all, 50 individuals (mean age, 60 ± 14 years; mean event-to-randomization, 23 ± 5 days; 29 men) participated. No adverse events occurred. BWSTT improved VO2peak by 30%, which was significantly greater than the 8% improvement observed for UC (P = .004 between groups). Similarly, there were significant Time × Group interactions for 6MWT and CMSR Foot, with BWSTT outperforming UC for gains in distance (P = .15; 48% vs. 19%, respectively) and stage (P = .01; 1.0 vs. 0.3, respectively). No group effect was seen for 10-m walk speed, BBS, or CMSR Leg, with both groups demonstrating significant gains. In general, gains observed were preserved for 12 months.
BWSTT elicits greater improvements in cardiovascular fitness and walking endurance than UC in the subacute poststroke period. These gains are largely sustained for 1 year.
支持体重的跑步机训练（BWSTT）用于训练健身和步行能力尚未得到研究。
比较 BWSTT 与等效剂量的常规护理（UC）在改善中风后早期心血管健康和步行能力方面的效果。
参与者被随机分配到以下 2 种干预措施之一：BWSTT+UC 或 UC。所有个体都接受了 6 周的住院治疗，每周进行 5 次 60 分钟的物理治疗，然后再进行 6 周的每周 3 次门诊治疗。基线、培训后、6 个月和 12 个月的随访结果测量如下：主要结果，健身（峰值耗氧量，VO2peak）和步行能力（6 分钟步行测试[6MWT]和 10 米步行）；次要结果，伯格平衡量表（BBS）和运动障碍（切多克-麦克马斯特康复阶段[CMSR]腿部和足部）。
共有 50 名参与者（平均年龄，60±14 岁；平均发病至随机分组时间，23±5 天；29 名男性）参与。未发生不良事件。BWSTT 使 VO2peak 提高了 30%，明显优于 UC 组的 8%改善（组间差异为 P =.004）。同样，6MWT 和 CMSR 足部的时间×组间交互作用显著，BWSTT 在距离（P =.15；分别为 48%和 19%）和阶段（P =.01；分别为 1.0 和 0.3）的改善方面优于 UC。10 米步行速度、BBS 和 CMSR 腿部均未观察到组间差异，两组均显示出显著改善。一般来说，12 个月时的改善仍能维持。
BWSTT 在亚急性期中风后引起的心血管健康和步行耐力的改善优于 UC。这些改善在 1 年内基本保持稳定。
