Chua Joyce, Culpan Jane, Menon Edward
Inpatient Therapy Services, St Andrew's Community Hospital, Singapore.
School of Health Sciences, University of East London, London, UK.
Arch Phys Med Rehabil. 2016 May;97(5):683-90. doi: 10.1016/j.apmr.2015.12.025. Epub 2016 Jan 21.
To evaluate the longer-term effects of electromechanical gait trainers (GTs) combined with conventional physiotherapy on health status, function, and ambulation in people with subacute stroke in comparison with conventional physiotherapy given alone.
Randomized controlled trial with intention-to-treat analysis.
Community hospital in Singapore.
Nonambulant individuals (N=106) recruited approximately 1 month poststroke.
Both groups received 45 minutes of physiotherapy 6 times per week for 8 weeks as follows: the GT group received 20 minutes of GT training and 5 minutes of stance/gait training in contrast with 25 minutes of stance/gait training for the control group. Both groups completed 10 minutes of standing and 10 minutes of cycling.
The primary outcome was the Functional Ambulation Category (FAC). Secondary outcomes were the Barthel Index (BI), gait speed and endurance, and Stroke Impact Scale (SIS). Measures were taken at baseline and 4, 8, 12, 24, and 48 weeks.
Generalized linear model analysis showed significant improvement over time (independent of group) for the FAC, BI, and SIS physical and participation subscales. However, no significant group × time or group differences were observed for any of the outcome variables after generalized linear model analysis.
The use of GTs combined with conventional physiotherapy can be as effective as conventional physiotherapy applied alone for people with subacute stroke.
与单独进行的传统物理治疗相比,评估机电步态训练器(GTs)联合传统物理治疗对亚急性中风患者健康状况、功能和步行能力的长期影响。
意向性分析的随机对照试验。
新加坡的社区医院。
中风后约1个月招募的非步行个体(N = 106)。
两组均每周接受6次,每次45分钟的物理治疗,共8周,具体如下:GT组接受20分钟的GT训练和5分钟的站立/步态训练,而对照组接受25分钟的站立/步态训练。两组均完成10分钟的站立和10分钟的骑行。
主要结局是功能性步行分类(FAC)。次要结局包括巴氏指数(BI)、步态速度和耐力以及中风影响量表(SIS)。在基线以及第4、8、12、24和48周进行测量。
广义线性模型分析显示,FAC、BI以及SIS身体和参与分量表随时间有显著改善(与组别无关)。然而,广义线性模型分析后,在任何结局变量上均未观察到显著的组×时间或组间差异。
对于亚急性中风患者,使用GTs联合传统物理治疗与单独应用传统物理治疗的效果相当。