Gama Gabriela L, Celestino Melissa L, Barela José A, Forrester Larry, Whitall Jill, Barela Ana M
Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil.
Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil; Department of Physical Education, São Paulo State University, Rio Claro, SP, Brazil.
Arch Phys Med Rehabil. 2017 Apr;98(4):738-745. doi: 10.1016/j.apmr.2016.11.022. Epub 2016 Dec 27.
To investigate the effects of gait training with body weight support (BWS) on a treadmill versus overground in individuals with chronic stroke.
Randomized controlled trial.
University research laboratory.
Individuals (N=28) with chronic stroke (>6mo from the stroke event).
Participants were randomly assigned to receive gait training with BWS on a treadmill (n=14) or overground (n=14) 3 times a week for 6 weeks.
Gait speed measured using the 10-meter walk test, endurance measured using the 6-minute walk test, functional independence measured using the motor domain of the FIM, lower limb recovery measured using the lower extremity domain of the Fugl-Meyer assessment, step length, step length symmetry ratio, and single-limb support duration. Measurements were obtained at baseline, immediately after the training session, and 6 weeks after the training session.
At 1 week after the last training session, both groups improved in all outcome measures except paretic step length and step length symmetry ratio, which were improved only in the overground group (P=.01 and P=.01, respectively). At 6 weeks after the last training session, all improvements remained and the treadmill group also improved paretic step length (P<.001) but not step length symmetry ratio (P>.05).
Individuals with chronic stroke equally improve gait speed and other gait parameters after 18 sessions of BWS gait training on either a treadmill or overground. Only the overground group improved step length symmetry ratio, suggesting a role of integrating overground walking into BWS interventions poststroke.
探讨在慢性卒中患者中，在跑步机上进行体重支持（BWS）步态训练与在地面上进行步态训练的效果差异。
随机对照试验。
大学研究实验室。
慢性卒中患者（N = 28）（卒中事件发生超过6个月）。
参与者被随机分配，一组（n = 14）在跑步机上接受每周3次、共6周的BWS步态训练，另一组（n = 14）在地面上接受同样训练。
使用10米步行试验测量步态速度，使用6分钟步行试验测量耐力，使用FIM运动领域评估功能独立性，使用Fugl-Meyer评估下肢领域测量下肢恢复情况，测量步长、步长对称率和单腿支撑持续时间。在基线、训练结束后即刻以及训练结束后6周进行测量。
在最后一次训练后1周，两组在所有观察指标上均有改善，但患侧步长和步长对称率除外，这两项指标仅在地面训练组有所改善（分别为P = 0.01和P = 0.01）。在最后一次训练后6周，所有改善均持续存在，跑步机训练组的患侧步长也有所改善（P < 0.001），但步长对称率未改善（P > 0.05）。
慢性卒中患者在跑步机或地面上进行18次BWS步态训练后，步态速度和其他步态参数均有同等程度改善。只有地面训练组的步长对称率得到改善，提示将地面行走纳入卒中后BWS干预措施可能具有一定作用。
