Jeong Yeon-Gyu, Koo Jung-Wan
a Department of Occupational and Environmental Medicine , The Catholic University of Korea, College of Medicine, and Industrial Medical Center Seoul St. Mary's Hospital , Seoul , Republic of Korea.
b Rehabilitation Medicine , Dongguk University Ilsan Medical Center , Goyang-si , Korea.
Top Stroke Rehabil. 2016 Dec;23(6):406-412. doi: 10.1080/10749357.2016.1168592. Epub 2016 May 20.
Treadmill walking training (TWT) provides greater amount and intensity of stepping practice than conventional walking training in patients with chronic stroke. However, there is not any conclusive evidence regarding the effects of TWT for ambulatory post-stroke patients. This study investigated the effects of treadmill walking combined with obstacle-crossing on the walking ability of ambulatory post-stroke patients.
Twenty-nine subjects from a university hospital-based rehabilitation center were randomly assigned to one of the following: experimental group (15 subjects) or control group (14 subjects). All subjects underwent 30 min of active/passive exercises and 30 min of gait training in the form of treadmill walking. The subjects in the experimental group underwent simultaneous training in obstacle-crossing while walking on the treadmill for 30 min/day, 5 times/week, for 4 weeks. Main measures were the 10-m walk test (10MWT), 6-min walk test (6MWT), Berg Balance Scale (BBS), timed "Up & Go" (TUG) test, and Activities-specific Balance Confidence (ABC) scale used before and after the intervention.
The changed values of the 6MWT and BBS were significantly higher in the experimental group than in the control group after adjusting for each baseline value, with large effects of 1.12 and 0.78, respectively, but not in the 10MWT, TUG, and ABC scale scores. Both groups showed a significant difference in all variables before and after the intervention.
Treadmill walking combined with obstacle-crossing training may help improve the walking ability of patients with hemiplegic stroke and can possibly be used as an adjunct to routine rehabilitation therapy as a task-oriented practice based on community ambulation.
对于慢性卒中患者，跑步机行走训练（TWT）比传统行走训练能提供更多的步数练习和更高的强度。然而，关于TWT对卒中后能行走患者的影响，尚无确凿证据。本研究调查了跑步机行走结合跨越障碍物对卒中后能行走患者步行能力的影响。
来自一家大学医院康复中心的29名受试者被随机分为以下两组之一：实验组（15名受试者）或对照组（14名受试者）。所有受试者均接受30分钟的主动/被动运动以及30分钟的跑步机行走形式的步态训练。实验组的受试者在跑步机上行走时同时进行跨越障碍物训练，每天30分钟，每周5次，共4周。主要测量指标为干预前后使用的10米步行测试（10MWT）、6分钟步行测试（6MWT）、伯格平衡量表（BBS）、定时起立行走测试（TUG）以及特定活动平衡信心量表（ABC）。
在对每个基线值进行调整后，实验组6MWT和BBS的变化值显著高于对照组，效应量分别为1.12和0.78，但在10MWT、TUG和ABC量表得分方面并非如此。两组在干预前后所有变量上均显示出显著差异。
跑步机行走结合跨越障碍物训练可能有助于改善偏瘫性卒中患者的步行能力，并有可能作为基于社区行走的任务导向性练习，用作常规康复治疗的辅助手段。
