Marsden Dianne Lesley, Dunn Ashlee, Callister Robin, McElduff Patrick, Levi Christopher Royce, Spratt Neil James
School of Medicine and Public Health and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia; Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
School of Biomedical Sciences and Pharmacy and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; Cardiovascular Research, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
J Stroke Cerebrovasc Dis. 2016 Oct;25(10):2386-98. doi: 10.1016/j.jstrokecerebrovasdis.2016.06.007. Epub 2016 Jul 1.
The cardiorespiratory fitness of stroke survivors is low. Center-based exercise programs that include an aerobic component have been shown to improve poststroke cardiorespiratory fitness. This pilot study aims to determine the feasibility, safety, and preliminary efficacy of an individually tailored home- and community-based exercise program to improve cardiorespiratory fitness and walking capacity in stroke survivors.
Independently ambulant, community-dwelling stroke survivors were recruited. The control (n = 10) and intervention (n = 10) groups both received usual care. In addition the intervention group undertook a 12-week, individually tailored, home- and community-based exercise program, including once-weekly telephone or e-mail support. Assessments were conducted at baseline and at 12 weeks. Feasibility was determined by retention and program participation, and safety by adverse events. Efficacy measures included change in cardiorespiratory fitness (peak oxygen consumption [VO2peak]) and distance walked during the Six-Minute Walk Test (6MWT). Analysis of covariance was used for data analysis.
All participants completed the study with no adverse events. All intervention participants reported undertaking their prescribed program. VO2peak improved more in the intervention group (1.17 ± .29 L/min to 1.35 ± .33 L/min) than the control group (1.24 ± .23 L/min to 1.24 ± .33 L/min, between-group difference = .18 L/min, 95% confidence interval [CI]: .01-.36). Distance walked improved more in the intervention group (427 ± 123 m to 494 ± 67m) compared to the control group (456 ± 101m to 470 ± 106m, between-group difference = 45 m, 95% CI: .3-90).
Our individually tailored approach with once-weekly telephone or e-mail support was feasible and effective in selected stroke survivors. The 16% greater improvement in VO2peak during the 6MWT achieved in the intervention versus control group is comparable to improvements attained in supervised, center-based programs.
中风幸存者的心肺适能较低。已证明包含有氧成分的基于中心的运动计划可改善中风后的心肺适能。这项试点研究旨在确定一项针对个人定制的家庭和社区运动计划在改善中风幸存者心肺适能和步行能力方面的可行性、安全性和初步疗效。
招募能够独立行走的社区中风幸存者。对照组（n = 10）和干预组（n = 10）均接受常规护理。此外，干预组进行了一项为期12周、针对个人定制的家庭和社区运动计划，包括每周一次的电话或电子邮件支持。在基线和12周时进行评估。可行性通过留存率和计划参与度来确定，安全性通过不良事件来确定。疗效指标包括心肺适能的变化（峰值耗氧量[VO2peak]）以及六分钟步行试验（6MWT）中的步行距离。采用协方差分析进行数据分析。
所有参与者均完成研究，无不良事件发生。所有干预组参与者均报告执行了规定的计划。干预组的VO2peak改善程度（从1.17±0.29升/分钟提高到1.35±0.33升/分钟）大于对照组（从1.24±0.23升/分钟提高到1.24±0.33升/分钟，组间差异=0.18升/分钟，95%置信区间[CI]：0.01 - 0.36）。与对照组（从456±101米提高到470±106米，组间差异=45米，95%CI：0.3 - 90）相比，干预组的步行距离改善程度更大（从427±123米提高到494±67米）。
我们针对个人定制的方法，辅以每周一次的电话或电子邮件支持，在选定的中风幸存者中是可行且有效的。干预组在6MWT期间VO2peak的改善程度比对照组高16%，这与在有监督的基于中心的计划中所取得的改善程度相当。
