Michaelsen Stella Maris, Ovando Angélica Cristiane, Romaguera Fernanda, Ada Louise
Department of Physical Therapy, Physical Therapy Master Program, Universidade do Estado de Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Int J Stroke. 2014 Jun;9(4):529-32. doi: 10.1111/ijs.12255. Epub 2014 Apr 15.
Residual walking deficits are common in people after stroke. Treadmill training can increase walking speed and walking distance. A new way to increase the challenge of walking is to walk backwards. Backward treadmill walking may provide advantages by promoting improvement in balance, walking spatiotemporal parameters and quality that may reflect in improving walking distance.
This study will test the hypothesis that backward treadmill walking is superior to forward treadmill walking in improving walking capacity, walking parameters, quality and balance in people with stroke.
A prospective, single-blinded, randomized trial will randomly allocate 88 community-dwelling people after stroke into either an experimental or control group. The experimental group will undertake 30-min sessions of backward treadmill walking, three-days/week for six-weeks, while the control group will undertake the same dose of forward treadmill walking. Training will begin at the baseline overground walking speed and will increase each week by 10% of baseline speed.
The primary outcome will be distance walked in the 6-min Walk Test. Secondary outcomes will be walking speed, step length, cadence, and one-leg stance time. Outcomes will be collected by a researcher blinded to group allocation at baseline (Week 0), at the end of training period (Week 6), and three-months after the cessation of intervention (Week 18).
If backward treadmill walking can improve walking capacity more than forward treadmill training in stroke, it may have broader implications because walking capacity has been shown to predict physical activity level and community participation.
中风患者残留行走功能障碍很常见。跑步机训练可以提高行走速度和行走距离。增加行走挑战的一种新方法是向后行走。向后跑步机行走可能通过促进平衡、行走时空参数和质量的改善而带来益处，这可能体现在行走距离的增加上。
本研究将检验以下假设：对于中风患者，向后跑步机行走在改善行走能力、行走参数、质量和平衡方面优于向前跑步机行走。
一项前瞻性、单盲、随机试验将把88名社区居住的中风患者随机分配到实验组或对照组。实验组将进行为期6周、每周3天、每次30分钟的向后跑步机行走训练，而对照组将进行相同剂量的向前跑步机行走训练。训练将从基线地面行走速度开始，每周以基线速度的10%递增。
主要结果将是6分钟步行试验中的行走距离。次要结果将是行走速度、步长、步频和单腿站立时间。结果将由一名对分组情况不知情的研究人员在基线（第0周）、训练期结束时（第6周）以及干预停止后三个月（第18周）收集。
如果向后跑步机行走在中风患者中比向前跑步机训练更能提高行走能力，可能会有更广泛的意义，因为行走能力已被证明可以预测身体活动水平和社区参与度。
