Physiotherapist, Rehabilitation, Aged Care, and Palliative Division, Southern Adelaide Local Health Network: c/o Flinders Medical Centre, Bedford Park, South Australia, Australia.
College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
J Stroke Cerebrovasc Dis. 2020 Jun;29(6):104758. doi: 10.1016/j.jstrokecerebrovasdis.2020.104758. Epub 2020 Mar 31.
Low cardiovascular fitness is common poststroke. Conventional subacute stroke rehabilitation does not meet Australian National Stroke Guidelines for cardiovascular exercise, particularly in mobility-dependent patients. Walking robotics can potentially achieve recommended cardiovascular exercise with these patients.
The primary aim was to determine whether sustained moderate intensity cardiovascular exercise can be achieved using 3 Lokomat Augmented Performance Feedback activities in mobility-dependent adults with subacute stroke. Secondary aims were to assess if cardiovascular workload was influenced by the activity completed, participants motivation or enjoyment, or changes in Lokomat settings.
Ten patients with subacute stroke (mean (SD) age: 63.4 (13) years) participated in 6x20-minute Lokomat study sessions. Each study session involved a warm-up and 3x5-minute APF activities presented in a random order. Metabolic data were collected using the COSMED-K5. Participants rated their perceived exertion on the BORG CR10 scale and Lokomat settings of body-weight support, guidance force, and speed were recorded.
Moderate intensity cardiovascular exercise was achieved and maintained over the 15 minutes of exercise, objectively demonstrated by a mean (SD) Metabolic Equivalent Task of 3.1 (1.3), and mean (SD) oxygen consumption of 8.0 (3.8) ml/kg/min, estimated as 52% VOmax. This was subjectively confirmed by exertion scores between 3 and 5. The cardiovascular workload was not affected by which activity was completed, participant motivation or enjoyment, or significant progression of Lokomat settings between study sessions.
Mobility-dependent patients with subacute stroke can achieve sustained moderate intensity cardiovascular exercise on the Lokomat when using APF activities.
脑卒中后心血管功能较差较为常见。传统亚急性期脑卒中康复治疗不符合澳大利亚国家脑卒中指南中关于心血管运动的建议，尤其是对于依赖于步行的患者。步行机器人在这些患者中可能实现推荐的心血管运动。
本研究的主要目的是确定在亚急性期脑卒中依赖于步行的成年人中，使用 3 种 Lokomat 增强性能反馈活动是否能实现持续的中等强度心血管运动。次要目的是评估完成的活动、参与者的动机或享受程度或 Lokomat 设置的变化是否会影响心血管工作量。
10 例亚急性期脑卒中患者（平均（SD）年龄：63.4（13）岁）参加了 6 次 20 分钟的 Lokomat 研究。每个研究均包括热身和 3 次 5 分钟的 APF 活动，以随机顺序呈现。使用 COSMED-K5 收集代谢数据。参与者使用 Borg CR10 量表评估他们的感知用力程度，记录 Lokomat 的体重支持、引导力和速度设置。
通过 15 分钟的运动，客观地证明代谢当量任务（MET）为 3.1（1.3），耗氧量为 8.0（3.8）ml/kg/min，估计为 52%最大摄氧量，实现了中等强度的心血管运动，并维持在中等强度。主观上通过 3 到 5 分的用力评分来确认。心血管工作量不受完成的活动、参与者的动机或享受程度或 Lokomat 设置在研究之间的显著进展的影响。
使用 Lokomat 的 APF 活动时，亚急性期脑卒中依赖于步行的患者可以实现持续的中等强度心血管运动。
