Sandberg Klas, Kleist Marie, Falk Lars, Enthoven Paul
Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden; Department of Internal Medicine, Vrinnevi Hospital, Norrköping, Sweden.
Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden.
Arch Phys Med Rehabil. 2016 Aug;97(8):1244-53. doi: 10.1016/j.apmr.2016.01.030. Epub 2016 Feb 20.
To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke.
Randomized controlled trial.
Ambulatory care.
Patients (N=56; 28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset.
Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise.
Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up.
The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001), TUG test (P<.001), SLS right and left (eyes open) (P<.001 and P=.022, respectively), and SLS right (eyes closed) (P=.019). Aerobic exercise was associated with improved EQ-5D scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up.
Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery.
探讨每周两次、为期12周的强化有氧运动对亚急性卒中后身体功能和生活质量的影响。
随机对照试验。
门诊护理。
年龄≥50岁、患有轻度卒中（98%为缺血性）且出院后能独立生活、在卒中发作后20天（中位数）入组的患者（N = 56；28名女性）。
每周两次、为期12周的60分钟团体有氧运动，包括两组8分钟的运动，运动强度在伯格主观用力程度量表上达到20分中的14或15级（n = 29）。非干预组（n = 27）未接受有组织的康复治疗或定期体育锻炼。
主要结局指标包括标准测力计运动应激试验中的有氧能力（峰值工作率）和6分钟步行试验（6MWT）中的步行距离。次要结局指标包括10米最大步行速度、定时起立行走试验（TUG）和单腿站立试验（SLS）中的平衡能力、欧洲生活质量量表（EQ - 5D）中与健康相关的生活质量，以及卒中影响量表（SIS）2.0版第8和第9领域中卒中后的参与度和恢复情况。在干预前后对参与者进行评估。还在6个月随访时评估患者报告的指标。
干预组在以下方面从干预前到干预后改善更为显著：峰值工作率（组×时间交互作用，P = .006）、6MWT（P = .011）、10米最大步行速度（P < .001）、TUG试验（P < .001）、双侧单腿站立试验（睁眼）（分别为P < .001和P = .022）以及右侧单腿站立试验（闭眼）（P = .019）。有氧运动与EQ - 5D评分改善（视觉模拟量表，P = .008）和自我感觉恢复（SIS第9领域，P = .002）相关。这些患者报告的改善在6个月随访时持续存在。
亚急性轻度卒中早期每周两次的强化有氧运动可改善有氧能力、步行能力、平衡能力、与健康相关的生活质量以及患者报告的恢复情况。
