Kelly Liam P, Devasahayam Augustine J, Chaves Arthur R, Wallack Elizabeth M, McCarthy Jason, Basset Fabien A, Ploughman Michelle
Recovery and Performance Lab, Faculty of Medicine, L.A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, Canada.
School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada.
Front Physiol. 2017 Oct 26;8:809. doi: 10.3389/fphys.2017.00809. eCollection 2017.
To determine whether stroke survivors could maintain workloads during functional task practice that can reach moderate levels of cardiometabolic stress (i.e., ≥40% oxygen uptake reserve ([Formula: see text]OR) for ≥20 min) without the use of ergometer-based exercise. Cross-sectional study using convenience sampling. Research laboratory in a tertiary rehabilitation hospital. Chronic hemiparetic stroke survivors (>6-months) who could provide consent and walk with or without assistance. A single bout of intermittent functional training (IFT). The IFT protocol lasted 30 min and involved performing impairment specific multi-joint task-oriented movements structured into circuits lasting ~3 min and allowing 30-45 s recovery between circuits. The aim was to achieve an average heart rate (HR) 30-50 beats above resting without using traditional ergometer-based aerobic exercise. Attainment of indicators for moderate intensity aerobic exercise. Oxygen uptake ([Formula: see text]O), carbon dioxide production ([Formula: see text]CO), and HR were recorded throughout the 30 min IFT protocol. Values were reported as percentage of [Formula: see text]OR, HR reserve (HRR) and HRR calculated from predicted maximum HR (HRR), which were determined from a prior maximal graded exercise test. Ten (3-female) chronic (38 ± 33 months) stroke survivors (70% ischemic) with significant residual impairments (NIHSS: 3 ± 2) and a high prevalence of comorbid conditions (80% ≥ 1) participated. IFT significantly increased all measures of exercise intensity compared to resting levels: [Formula: see text]O (Δ 820 ± 290 ml min, < 0.001), HR (Δ 42 ± 14 bpm, < 0.001), and energy expenditure (EE; Δ 4.0 ± 1.4 kcal min, < 0.001). Also, mean values for percentage of [Formula: see text]OR (62 ± 19), HRR (55 ± 14), and HRR (52 ± 18) were significantly higher than the minimum threshold (40%) indicating achievement of moderate intensity aerobic exercise ( = 0.004, 0.016, and 0.043, respectively). Sufficient workloads to achieve moderate levels of cardiometabolic stress can be maintained in chronic stroke survivors using impairment-focused functional movements that are not dependent on ergometers or other specialized equipment.
为了确定中风幸存者在不使用基于测力计的运动的情况下，进行功能任务练习时能否维持可达到中等水平心脏代谢应激（即≥40%摄氧量储备（[公式：见正文]OR）持续≥20分钟）的工作量。采用便利抽样的横断面研究。在一家三级康复医院的研究实验室进行。能够提供知情同意且无论有无辅助均可行走的慢性偏瘫中风幸存者（>6个月）。进行一轮间歇性功能训练（IFT）。IFT方案持续30分钟，包括进行针对损伤的多关节任务导向性运动，这些运动被组织成持续约3分钟的循环，并在循环之间允许30 - 45秒的恢复时间。目的是在不使用传统基于测力计的有氧运动的情况下，使平均心率（HR）比静息心率高30 - 50次/分钟。达到中等强度有氧运动的指标。在整个30分钟的IFT方案中记录摄氧量（[公式：见正文]O）、二氧化碳产生量（[公式：见正文]CO）和HR。数值以[公式：见正文]OR的百分比、心率储备（HRR）以及根据预测最大心率计算的心率储备（HRR）报告，这些是根据先前的最大分级运动试验确定的。十名（3名女性）慢性（38±33个月）中风幸存者（70%为缺血性），有明显的残余损伤（美国国立卫生研究院卒中量表：3±2）且合并症患病率高（80%≥1）参与了研究。与静息水平相比，IFT显著增加了所有运动强度指标：[公式：见正文]O（Δ820±290毫升/分钟，<0.001）、HR（Δ42±14次/分钟，<0.001）和能量消耗（EE；Δ4.0±1.4千卡/分钟，<0.001）。此外，[公式：见正文]OR的百分比（62±19）、HRR（55±14）和HRR（52±18）的平均值显著高于最低阈值（40%），表明达到了中等强度有氧运动（分别为=0.004、0.016和0.043）。使用不依赖测力计或其他专业设备的以损伤为重点的功能运动，慢性中风幸存者能够维持足够的工作量以达到中等水平的心脏代谢应激。
