Vahlberg Birgit, Cederholm Tommy, Lindmark Birgitta, Zetterberg Lena, Hellström Karin
a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden.
b Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism , Uppsala University , Uppsala , Sweden.
Disabil Rehabil. 2017 Aug;39(16):1615-1622. doi: 10.1080/09638288.2016.1206631. Epub 2016 Jul 14.
To evaluate the effects of progressive resistance and balance (PRB) exercises on physical and psychological functions of post-stroke individuals.
In a randomized controlled trial with follow-up at 3, 6 and 15 months, 67 community-living individuals (76% male; 65-85 years) with a stroke 1-3 years previously were allocated to an intervention group (IG, n = 34; PRB exercises combined with motivational group discussions twice weekly for 3 months) or a control group (CG, n = 33). The primary outcomes were balance (Berg Balance Scale, 0-56 points) and mobility (Short Physical Performance Battery, 0-12 points) at 3 months. The secondary outcomes were 10 m comfortable walking speed, physical activity levels, health-related quality of life, depression and fall-related self-efficacy.
At 3 months, the IG exhibited significant improvements in balance (MD 2.5 versus 0 points; effect size [ES], 0.72; p < 0.01) and comfortable walking speed (MD 0.04 versus -0.05 m/s; ES, 0.68; p = 0.01) relative to the CG. A faster walking speed persisted at 6 months. No differences were found for the other outcomes.
In chronic stroke patients, 3 months of PRB exercises and motivational discussions induced improvements in balance at 3 months and in walking speed at 3 and 6 months. Implications for Rehabilitation A progressive resistance and balance exercise program supported by motivational group discussions and one home-based exercise appears to be an effective means of improving the short-term balance and the walking speed in individuals with chronic stroke. People with poor balance and motor function discontinued the study more often and may require additional support. There is a need for powerful and cost-effective strategies that target changes in behavior to obtain long-term changes in physical function after exercising.
评估渐进性抗阻和平衡（PRB）训练对中风后个体身体和心理功能的影响。
在一项随机对照试验中，对67名1至3年前中风的社区居住个体（76%为男性；年龄65 - 85岁）进行3个月、6个月和15个月的随访，将其分为干预组（IG，n = 34；PRB训练结合每周两次的激励性小组讨论，为期3个月）或对照组（CG，n = 33）。主要结局指标为3个月时的平衡能力（伯格平衡量表，0 - 56分）和活动能力（简短体能状况量表，0 - 12分）。次要结局指标为10米舒适步行速度、身体活动水平、健康相关生活质量、抑郁及跌倒相关自我效能感。
在3个月时，相对于CG组而言，IG组在平衡能力（平均差值2.5分对0分；效应量[ES]，0.72；p < 0.01）和舒适步行速度（平均差值0.04米/秒对 - 0.05米/秒；ES，0.68；p = 0.01）方面有显著改善。6个月时步行速度仍较快。其他结局指标未发现差异。
在慢性中风患者中，3个月的PRB训练和激励性讨论可使3个月时的平衡能力以及3个月和6个月时的步行速度得到改善。康复意义 由激励性小组讨论和一项家庭锻炼支持的渐进性抗阻和平衡训练计划似乎是改善慢性中风个体短期平衡能力和步行速度的有效方法。平衡能力和运动功能较差的人更常退出研究，可能需要额外支持。需要有强有力且具有成本效益的策略来针对行为改变，以在锻炼后获得身体功能的长期改变。
