Boyne Pierce, Billinger Sandra, MacKay-Lyons Marilyn, Barney Brian, Khoury Jane, Dunning Kari
Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati (P.B., B.B., K.D.), Department of Environmental Health, College of Medicine, University of Cincinnati (P.B., J.K., K.D.), and Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center (J.K.), Cincinnati, Ohio; Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City (S.B.); and School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada (M.M.-L.).
J Neurol Phys Ther. 2017 Apr;41(2):119-128. doi: 10.1097/NPT.0000000000000177.
Best practice recommendations indicate that aerobic exercise (AEX) should be incorporated into stroke rehabilitation. However, this may be challenging in clinical settings. The purpose of this study was to assess physical therapist (PT) AEX prescription for patients with stroke, including AEX utilization, barriers to AEX prescription, dosing parameters, and safety considerations.
A cross-sectional Web-based survey study was conducted. Physical therapists with valid e-mail addresses on file with the state boards of Florida, New Jersey, Ohio, Texas, and Wyoming were eligible to participate. Survey invitations were e-mailed to all licensed PT in these states. Analysis focused on respondents who were currently involved with clinical stroke rehabilitation in common practice settings.
Results from 568 respondents were analyzed. Most respondents (88%) agreed that AEX should be incorporated into stroke rehabilitation, but 84% perceived at least one barrier. Median prescribed AEX volume varied between practice settings from 20- to 30-minute AEX sessions, 3 to 5 days per week for 2 to 8 weeks. Prescribed intensity was most commonly light or moderate; intensity was determined by the general response to AEX and patient feedback. Only 2% of respondents reported that the majority of their patients with stroke had stress tests.
Most US PTs appear to recognize the importance of AEX for persons poststroke, but clinical implementation can be challenging. Future studies and consensus are needed to clarify best practices and to develop implementation interventions to optimize AEX utilization in stroke rehabilitation.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A167).
最佳实践建议指出，有氧运动（AEX）应纳入中风康复治疗中。然而，在临床环境中这可能具有挑战性。本研究的目的是评估物理治疗师（PT）为中风患者开具的AEX处方，包括AEX的使用情况、AEX处方的障碍、剂量参数和安全考虑因素。
进行了一项基于网络的横断面调查研究。在佛罗里达州、新泽西州、俄亥俄州、得克萨斯州和怀俄明州州立委员会存档有有效电子邮件地址的物理治疗师有资格参与。向这些州的所有持牌PT发送了调查邀请电子邮件。分析集中在当前在常见实践环境中参与临床中风康复的受访者。
分析了568名受访者的结果。大多数受访者（88%）同意AEX应纳入中风康复，但84%的人认为至少存在一个障碍。不同实践环境中规定的AEX时长中位数为每次20至30分钟，每周3至5天，持续2至8周。规定的强度最常见的是轻度或中度；强度由对AEX的总体反应和患者反馈决定。只有2%的受访者报告说他们的大多数中风患者进行了压力测试。
大多数美国物理治疗师似乎认识到AEX对中风后患者的重要性，但临床实施可能具有挑战性。需要未来的研究和共识来阐明最佳实践，并制定实施干预措施，以优化中风康复中AEX的使用。可获取视频摘要以获得作者更多见解（见视频，补充数字内容1，http://links.lww.com/JNPT/A167）。
