Combs-Miller Stephanie A, Kalpathi Parameswaran Anu, Colburn Dawn, Ertel Tara, Harmeyer Amanda, Tucker Lindsay, Schmid Arlene A
Krannert School of Physical Therapy, University of Indianapolis, IN, USA
Krannert School of Physical Therapy, University of Indianapolis, IN, USA.
Clin Rehabil. 2014 Sep;28(9):873-84. doi: 10.1177/0269215514520773. Epub 2014 Feb 11.
To compare the effects of body weight-supported treadmill training and overground walking training when matched for task and dose (duration/frequency/intensity) on improving walking function, activity, and participation after stroke.
Single-blind, pilot randomized controlled trial with three-month follow-up.
University and community settings.
A convenience sample of participants (N = 20) at least six months post-stroke and able to walk independently were recruited.
Thirty-minute walking interventions (body weight-supported treadmill training or overground walking training) were administered five times a week for two weeks. Intensity was monitored with the Borg Rating of Perceived Exertion Scale at five-minute increments to maintain a moderate training intensity.
Walking speed (comfortable/fast 10-meter walk), walking endurance (6-minute walk), spatiotemporal symmetry, and the ICF Measure of Participation and ACTivity were assessed before, immediately after, and three months following the intervention.
The overground walking training group demonstrated significantly greater improvements in comfortable walking speed compared with the body weight-supported treadmill training group immediately (change of 0.11 m/s vs. 0.06 m/s, respectively; p = 0.047) and three months (change of 0.14 m/s vs. 0.08 m/s, respectively; p = 0.029) after training. Only the overground walking training group significantly improved comfortable walking speed (p = 0.001), aspects of gait symmetry (p = 0.032), and activity (p = 0.003) immediately after training. Gains were maintained at the three-month follow-up (p < 0.05) for all measures except activity. Improvements in participation were not demonstrated.
Overgound walking training was more beneficial than body weight-supported treadmill training at improving self-selected walking speed for the participants in this study.
比较在任务和剂量（持续时间/频率/强度）相匹配的情况下，减重平板训练与地面行走训练对改善中风后步行功能、活动能力和参与度的效果。
单盲、试点随机对照试验，随访三个月。
大学和社区环境。
招募了中风后至少六个月且能够独立行走的方便样本参与者（N = 20）。
进行为期两周、每周五次、每次30分钟的步行干预（减重平板训练或地面行走训练）。使用伯格主观用力程度量表每五分钟监测一次强度，以维持中等训练强度。
在干预前、干预后即刻以及干预后三个月评估步行速度（舒适/快速10米步行）、步行耐力（6分钟步行）、时空对称性以及国际功能、残疾和健康分类（ICF）参与和活动测量指标。
与减重平板训练组相比，地面行走训练组在训练后即刻（分别变化0.11米/秒和0.06米/秒；p = 0.047）和三个月时（分别变化0.14米/秒和0.08米/秒；p = 0.029），舒适步行速度有显著更大的改善。仅地面行走训练组在训练后即刻舒适步行速度（p = 0.001）、步态对称性方面（p = 0.032）和活动能力（p = 0.003）有显著改善。除活动能力外，所有测量指标在三个月随访时改善情况得以维持（p < 0.05）。未显示出参与度的改善。
在本研究中，对于参与者而言，地面行走训练在提高自我选择的步行速度方面比减重平板训练更有益。
