1 Toronto Rehab-University Health Network, Toronto, ON, Canada.
2 University of Toronto, Toronto, ON, Canada.
Neurorehabil Neural Repair. 2018 Mar;32(3):209-222. doi: 10.1177/1545968318765692. Epub 2018 Mar 30.
Stroke is associated with muscle atrophy and weakness, mobility deficits, and cardiorespiratory deconditioning. Aerobic and resistance training (AT and RT) each have the potential to improve deficits, yet there is limited evidence on the utility of combined training.
To examine the effects of AT+RT versus AT on physiological outcomes in chronic stroke with motor impairments.
Participants (n = 73) were randomized to 6 months of AT (5 d/wk) or AT+RT (3 and 2 d/wk, respectively). Outcomes included those related to body composition by dual-energy X-ray absorptiometry, mobility (6-minute walk distance [6MWD], sit-to-stand, and stair climb performance), cardiorespiratory fitness (VO, oxygen uptake at the ventilatory threshold [VO]), and muscular strength.
A total of 68 (93.2%) participants (age, mean ± SD = 63.7 ± 11.9) completed the study. AT+RT and AT yielded similar and significant improvements in 6MWD (39.9 ± 55.6 vs 36.5 ± 63.7 m, P = .8), VO (16.4% ± 43.8% vs 15.2% ± 24.7%, P = .9), sit-to-stand time (-2.3 ± 5.1 vs 1.02 ± 9.5 s, P = .05), and stair climb performance (8.2% ± 19.6% vs 7.5% ± 23%, P = .97), respectively. AT+RT produced greater improvements than AT alone for total body lean mass (1.23 ± 2.3 vs 0.27 ± 1.6 kg, P = .039), predominantly trunk ( P = .02) and affected-side limbs ( P = .04), VO (19.1% ± 26.8% vs 10.5% ± 28.9%, P = .046), and upper- and lower-limb muscular strength ( P < .03, all except affected-side leg).
Despite being prescribed 40% less AT, AT+RT resulted in similar and significant improvement in mobility and VO, superior improvements in VO and muscular strength, and an almost 5-fold greater increase in lean mass compared with AT. RT is the most neglected exercise component following stroke but should be prescribed with AT for metabolic, cardiorespiratory, and strength recovery.
中风会导致肌肉萎缩和无力、活动能力受损以及心肺功能下降。有氧运动和抗阻训练（AT 和 RT）都有可能改善这些缺陷，但关于联合训练的效果证据有限。
研究慢性中风伴运动障碍患者进行 AT+RT 与 AT 相比对生理结果的影响。
将 73 名参与者随机分为 6 个月的 AT（每周 5 天）或 AT+RT（每周分别 3 天和 2 天）。结果包括通过双能 X 射线吸收法评估的身体成分、活动能力（6 分钟步行距离[6MWD]、从座位到站起、爬楼梯表现）、心肺功能（VO，摄氧量达到通气阈[VO]）和肌肉力量。
共有 68 名（93.2%）参与者（年龄，平均值 ± 标准差=63.7 ± 11.9）完成了研究。AT+RT 和 AT 在 6MWD（39.9 ± 55.6 比 36.5 ± 63.7 m，P=.8）、VO（16.4% ± 43.8% 比 15.2% ± 24.7%，P=.9）、从座位到站起时间（-2.3 ± 5.1 比 1.02 ± 9.5 s，P=.05）和爬楼梯表现（8.2% ± 19.6% 比 7.5% ± 23%，P=.97）方面分别取得了相似且显著的改善。AT+RT 比单独 AT 更能改善全身去脂体重（1.23 ± 2.3 比 0.27 ± 1.6 kg，P=.039），主要是躯干（P=.02）和患侧肢体（P=.04），VO（19.1% ± 26.8% 比 10.5% ± 28.9%，P=.046）和上下肢肌肉力量（P<.03，除患侧腿部外均如此）。
尽管 AT 的处方量减少了 40%，但 AT+RT 对活动能力和 VO 的改善仍相似且显著，对 VO 和肌肉力量的改善更优，与 AT 相比，去脂体重增加了近 5 倍。RT 是中风后最被忽视的运动成分，但应与 AT 一起用于代谢、心肺和力量恢复。
