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联合有氧运动和任务练习改善卒中后健康相关生活质量:初步分析。

Combined Aerobic Exercise and Task Practice Improve Health-Related Quality of Life Poststroke: A Preliminary Analysis.

机构信息

Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.

Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH; Neurological Institute, Cleveland Clinic, Cleveland, OH.

出版信息

Arch Phys Med Rehabil. 2019 May;100(5):923-930. doi: 10.1016/j.apmr.2018.11.011. Epub 2018 Dec 10.

Abstract

OBJECTIVE

The aim of this project was to determine the effects of lower extremity aerobic exercise coupled with upper extremity repetitive task practice (RTP) on health-related quality of life (HRQOL) and depressive symptomology in individuals with chronic stroke.

DESIGN

Secondary analysis of data from 2 randomized controlled trials.

SETTING

Research laboratory.

PARTICIPANTS

Individuals (N=40) with chronic stroke.

INTERVENTIONS

Participants received one of the following interventions: forced exercise+RTP (FE+RTP, n=16), voluntary exercise+RTP (VE+RTP, n=16), or stroke education+RTP (EDU+RTP, n=8). All groups completed 24 sessions, each session lasting 90 minutes.

MAIN OUTCOME MEASURES

The Center for Epidemiological Studies-Depression Scale (CES-D) and Stroke Impact Scale (SIS) were used to assess depressive symptomology and HRQOL.

RESULTS

There were no significant group-by-time interactions for any of the SIS domains or composite scores. Examining the individual groups following the intervention, those in the FE+RTP and VE+RTP groups demonstrated significant improvements in the following SIS domains: strength, mobility, hand function, activities of daily living, and the physical composite. In addition, the FE+RTP group demonstrated significant improvements in memory, cognitive composite, and percent recovery from stroke. The HRQOL did not change in the EDU+RTP group. Although CES-D scores improved predominantly for those in the FE+RTP group, these improvements were not statistically significant. Overall, results were maintained at the 4-week follow-up.

CONCLUSION

Aerobic exercise, regardless of mode, preceding motor task practice may improve HRQOL in patients with stroke. The potential of aerobic exercise to improve cardiorespiratory endurance, motor outcomes, and HRQOL poststroke justifies its use to augment traditional task practice.

摘要

目的

本项目旨在确定下肢有氧运动结合上肢重复任务练习(RTP)对慢性脑卒中患者健康相关生活质量(HRQOL)和抑郁症状的影响。

设计

对 2 项随机对照试验数据的二次分析。

设置

研究实验室。

参与者

慢性脑卒中患者(N=40)。

干预措施

参与者接受以下干预措施之一:强制运动+RTP(FE+RTP,n=16)、自愿运动+RTP(VE+RTP,n=16)或脑卒中教育+RTP(EDU+RTP,n=8)。所有组均完成 24 次疗程,每次 90 分钟。

主要观察指标

采用流行病学研究中心抑郁量表(CES-D)和脑卒中影响量表(SIS)评估抑郁症状和 HRQOL。

结果

在 SIS 各领域或综合评分方面,无显著组间时间交互作用。干预后对各单独组进行检查,FE+RTP 和 VE+RTP 组在以下 SIS 领域和综合评分方面表现出显著改善:力量、活动能力、手部功能、日常生活活动和身体综合评分。此外,FE+RTP 组在记忆、认知综合评分和脑卒中康复比例方面也有显著改善。EDU+RTP 组的 HRQOL 没有变化。尽管 FE+RTP 组的 CES-D 评分普遍提高,但这些改善无统计学意义。总体而言,结果在 4 周随访时仍保持不变。

结论

无论运动模式如何,有氧运动在前导运动任务练习之前可能会改善脑卒中患者的 HRQOL。有氧运动提高心肺耐力、运动结果和脑卒中后 HRQOL 的潜力证明了其在增强传统任务练习中的应用价值。

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