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中风后的物理治疗与身体功能:4年后的运动习惯与身体功能?1年长期干预期后的长期随访:一项随机对照试验。

Physiotherapy and physical functioning post-stroke: exercise habits and functioning 4 years later? Long-term follow-up after a 1-year long-term intervention period: a randomized controlled trial.

作者信息

Langhammer Birgitta, Lindmark Birgitta, Stanghelle Johan K

机构信息

Faculty of Health, Oslo and Akershus University College , Oslo , Norway .

出版信息

Brain Inj. 2014;28(11):1396-405. doi: 10.3109/02699052.2014.919534. Epub 2014 Jun 19.

Abstract

INTRODUCTION

Physical activity is mandatory if patients are to remain healthy and independent after stroke.

OBJECTIVE

Maintenance of motor function, tone, grip strength, balance, mobility, gait, independence in personal and instrumental activities of daily living, health-related quality-of-life and an active lifestyle 4 years post-stroke.

METHODS

A prospective randomized controlled trial.

RESULTS

Four years post-stroke, 37 of the 75 participating persons were eligible for follow-up; 19 (54.3%) from the intensive exercise group and 18 (45%) from the regular exercise group. Both groups were performing equally well with no significant differences in total scores on the BI (p = 0.3), MAS (p = 0.4), BBS (p = 0.1), TUG (p = 0.08), 6MWT (p = 0.1), bilateral grip strength (affected hand, p = 0.8; non-affected hand, p = 0.9) nor in the items of NHP (p > 0.005). Independence in performing the IADL was 40%, while 60% had help from relatives or community-based services.

CONCLUSION

This longitudinal study shows that persons with stroke in two groups with different exercise regimes during the first year after stroke did not differ in long-term outcomes. Both groups maintained function and had a relatively active life style 4 years after the acute incident. The results underline the importance of follow-up testing and encouragement to exercise, to motivate and sustain physical activity patterns, to maintain physical function, not only in the acute but also in the chronic phase of stroke.

摘要

引言

若患者想要在中风后保持健康和独立,体育活动是必不可少的。

目的

中风后4年维持运动功能、肌张力、握力、平衡能力、活动能力、步态、日常生活个人和工具性活动的独立性、与健康相关的生活质量以及积极的生活方式。

方法

一项前瞻性随机对照试验。

结果

中风后4年,75名参与研究的人员中有37人符合随访条件;强化运动组19人(54.3%),常规运动组18人(45%)。两组表现相当,在巴氏指数(BI)总分(p = 0.3)、改良Ashworth量表(MAS)(p = 0.4)、Berg平衡量表(BBS)(p = 0.1)、定时起立行走测试(TUG)(p = 0.08)、6分钟步行试验(6MWT)(p = 0.1)、双侧握力(患侧手,p = 0.8;非患侧手,p = 0.9)以及诺丁汉健康量表(NHP)各项(p > 0.005)方面均无显著差异。独立完成工具性日常生活活动的比例为40%,而60%的人得到了亲属或社区服务的帮助。

结论

这项纵向研究表明,中风后第一年接受不同运动方案的两组中风患者在长期预后方面并无差异。两组在急性事件发生4年后均维持了功能,并拥有相对积极的生活方式。结果强调了随访测试以及鼓励运动的重要性,以激发和维持体育活动模式,不仅在中风急性期,而且在慢性期也要维持身体功能。

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