Bae Young-Hyeon, Lee Suk Min, Ko Mansoo
a Department of Physical Therapy , Samsung Medical Center , Seoul , Republic of Korea.
b Department of Physical Therapy , Angelo State University , San Angelo , TX , USA.
Top Stroke Rehabil. 2017 May;24(4):309-313. doi: 10.1080/10749357.2016.1275304. Epub 2017 Jan 19.
Robot-assisted gait training (RAGT) is effective for improving dynamic balance and aerobic capacity, but previous RAGT method does not set suitable training intensity. Recently, high-intensity treadmill gait training at 70% of heart rate reserve (HRR) was used for improving aerobic capacity and dynamic balance.
This study was designed to compare the effectiveness between objective and subjective methods of high-intensity RAGT for improving dynamic balance and aerobic capacity in chronic stroke.
Subjects were randomly allocated into experimental (n = 17) and control (n = 17) groups. The experimental group underwent high-intensity RAGT at 70% of HRR, whereas the control group underwent high-intensity RAGT at an RPE of 15. Both groups received their assigned training for 30 min per session, 3 days per week for 6 weeks. All subjects also received an additional 30 min of conventional physical therapy. Before and after each of the 18 sessions, the dynamic balance and aerobic capacity of all subjects were evaluated by a blinded examiner.
After training, Berg Balance Scale (BBS) and Timed Up and Go Test scores, VOmax, and VOmax/kg were significantly increased in both groups (p < 0.05). These variables in experimental group were significantly greater than control group. However, the BBS score was not significantly different between both groups. All subjects completed high-intensity RAGT. No adverse effect of training was observed in both groups.
High-intensity RAGT at 70% of HRR significantly improved dynamic balance and aerobic capacity more than RAGT at RPE of 15. These results suggest that high-intensity RAGT at 70% of HRR is safe and effective for improving dynamic balance and aerobic capacity in chronic stroke.
机器人辅助步态训练（RAGT）对改善动态平衡和有氧运动能力有效，但以往的RAGT方法未设定合适的训练强度。最近，采用心率储备（HRR）70%的高强度跑步机步态训练来改善有氧运动能力和动态平衡。
本研究旨在比较高强度RAGT的客观和主观方法对改善慢性卒中患者动态平衡和有氧运动能力的效果。
将受试者随机分为实验组（n = 17）和对照组（n = 17）。实验组进行HRR 70%的高强度RAGT，而对照组进行主观用力程度（RPE）为15的高强度RAGT。两组均接受指定训练，每次训练30分钟，每周3天，共6周。所有受试者还额外接受30分钟的传统物理治疗。在18次训练的每次前后，由一位不知情的检查者评估所有受试者的动态平衡和有氧运动能力。
训练后，两组的伯格平衡量表（BBS）、计时起立行走测试得分、最大摄氧量（VOmax）和每千克体重最大摄氧量（VOmax/kg）均显著提高（p < 0.05）。实验组的这些变量显著高于对照组。然而，两组之间的BBS得分无显著差异。所有受试者均完成了高强度RAGT。两组均未观察到训练的不良反应。
HRR 70%的高强度RAGT比RPE为15的RAGT更能显著改善动态平衡和有氧运动能力。这些结果表明，HRR 70%的高强度RAGT对改善慢性卒中患者的动态平衡和有氧运动能力是安全有效的。
