Prout Erik C, Brooks Dina, Mansfield Avril, Bayley Mark, McIlroy William E
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute (University Health Network), Toronto, ON, Canada.
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Toronto Rehabilitation Institute (University Health Network), Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, ON, Canada.
Arch Phys Med Rehabil. 2015 May;96(5):823-30. doi: 10.1016/j.apmr.2014.12.005. Epub 2014 Dec 23.
To identify patient characteristics that influence physiotherapist's decisions on enrollment and attendance in a structured aerobic exercise program early after stroke.
Retrospective chart review.
Rehabilitation hospital.
Consecutive sample of people (N=345) admitted to inpatient stroke rehabilitation over a 2-year period.
Not applicable.
Patient demographic characteristics, preexisting medical conditions, and poststroke outcome variables (neurological deficit, physical impairment, balance control, and functional mobility and independence) were compared between individuals enrolled and not enrolled in a structured aerobic exercise program. The rate of attendance was calculated for the enrolled group.
One hundred twenty-nine patients (38%) were enrolled in the structured aerobic exercise program. Patients who were older (P=.0093) and had cardiac disease (P=.012), cardioembolic sources (P=.0094), and arthritis (P=.031) were less likely to be enrolled in the structured aerobic exercise program. Poststroke outcome variables were not associated with enrollment. Among those enrolled, the rate of attendance was positively correlated with the FIM cognitive rating (r=.27; P=.0031).
Enrollment in structured aerobic exercise programs during inpatient stroke rehabilitation can be limited by safety concerns related to patients' cardiovascular and musculoskeletal status. Barriers associated with the perception of cardiovascular risk factors should be confronted because they do not preclude participation in cardiac rehabilitation. In addition, poststroke deficits do not limit participation in adapted aerobic exercise early after stroke. It is likely that the characteristics of the structured aerobic exercise program were integral to accommodate the breadth of poststroke deficits encountered in this study. Future research investigating physiotherapist and practice environment factors that influence the decision to prescribe and implement aerobic exercise is warranted.
确定影响物理治疗师对中风后早期参加有组织的有氧运动计划的注册和出勤决策的患者特征。
回顾性病历审查。
康复医院。
连续两年内入住中风康复病房的患者样本（N = 345）。
不适用。
比较参加和未参加有组织的有氧运动计划的个体之间的患者人口统计学特征、既往病史和中风后结局变量（神经功能缺损、身体损伤、平衡控制以及功能活动能力和独立性）。计算注册组的出勤率。
129名患者（38%）参加了有组织的有氧运动计划。年龄较大（P = .0093）、患有心脏病（P = .012）、心源性栓塞源（P = .0094）和关节炎（P = .031）的患者参加有组织的有氧运动计划的可能性较小。中风后结局变量与注册无关。在参加者中，出勤率与FIM认知评分呈正相关（r = .27；P = .0031）。
住院中风康复期间参加有组织的有氧运动计划可能会受到与患者心血管和肌肉骨骼状况相关的安全问题的限制。应消除与心血管危险因素认知相关的障碍，因为这些因素并不妨碍参与心脏康复。此外，中风后缺损并不限制中风后早期参加适应性有氧运动。有组织的有氧运动计划的特点可能是适应本研究中遇到的中风后缺损范围的关键。有必要开展未来研究，调查影响有氧运动处方和实施决策的物理治疗师及实践环境因素。
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