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脑卒中后人群池底行走的心肺反应。

Cardiorespiratory Responses to Pool Floor Walking in People Poststroke.

机构信息

Department of Kinesiology, California State University, Northridge, Northridge, CA.

Department of Kinesiology, California State University, Northridge, Northridge, CA.

出版信息

Arch Phys Med Rehabil. 2018 Mar;99(3):542-547. doi: 10.1016/j.apmr.2017.09.112. Epub 2017 Oct 5.

Abstract

OBJECTIVE

To compare cardiorespiratory responses between pool floor walking and overground walking (OW) in people poststroke.

DESIGN

Cross-sectional study.

SETTING

University-based therapeutic exercise facility.

PARTICIPANTS

Participants (N=28) were comprised of 14 community-dwelling individuals poststroke (5.57±3.57y poststroke) and 14 age- and sex-matched healthy adults (mean age, 58.00±15.51y; male/female ratio, 9:5).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

A telemetric metabolic system was used to collect cardiorespiratory variables, including oxygen consumption (V˙o), energy expenditure (EE), and expired volume per unit time (V˙e), during 6-minute walking sessions in chest-depth water and on land at a matched speed, determined by average of maximum walking speed in water.

RESULTS

Individuals poststroke elicited no significant differences in cardiorespiratory responses between pool floor walking and OW. However, healthy controls showed significant increases in mean V˙o values by 94%, EE values by 109%, and V˙e values by 94% (all P<.05) during pool floor walking compared with OW. A 2×2 mixed model analysis of variance revealed a significant group × condition interaction in V˙o, in which the control group increased V˙o from OW to pool floor walking, whereas the stroke group did not.

CONCLUSIONS

Our results indicate that people poststroke, unlike healthy adults, do not increase EE while walking in water compared with on land. Unlike stationary walking on an aquatic treadmill, forward locomotion during pool floor walking at faster speeds may have increased drag force, which requires greater EE from healthy adults. Without demanding excessive EE, walking in water may offer a naturally supportive environment for gait training in the early stages of rehabilitation.

摘要

目的

比较脑卒中后患者在泳池底行走和地面行走(OW)时的心肺反应。

设计

横断面研究。

地点

大学治疗性运动设施。

参与者

参与者(N=28)由 14 名居住在社区的脑卒中后患者(脑卒中后 5.57±3.57 年)和 14 名年龄和性别匹配的健康成年人(平均年龄 58.00±15.51 岁;男女比例 9:5)组成。

干预措施

不适用。

主要观察指标

使用遥测代谢系统收集心肺变量,包括氧耗量(V˙o)、能量消耗(EE)和单位时间呼气量(V˙e),在 6 分钟的行走过程中,患者在水深为胸部深度的水中和在陆地上以匹配的速度行走,该速度由水中最大行走速度的平均值决定。

结果

脑卒中后患者在泳池底行走和 OW 时的心肺反应无显著差异。然而,与 OW 相比,健康对照组在泳池底行走时 V˙o 值平均增加 94%,EE 值增加 109%,V˙e 值增加 94%(均 P<.05)。2×2 混合模型方差分析显示,组×条件的交互作用在 V˙o 中具有统计学意义,其中对照组从 OW 到泳池底行走时 V˙o 增加,而脑卒中组则没有。

结论

我们的结果表明,与健康成年人不同,脑卒中后患者在水中行走时不会像在陆地上那样增加 EE。与在水上固定行走不同,在泳池底以更快的速度向前行走可能会增加阻力,这需要健康成年人增加 EE。在水中行走不需要过高的 EE,它可能为康复早期的步态训练提供一个自然支持的环境。

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