Indiana University School of Medicine, Indianapolis IN, USA.
Rehabilitation Hospital of Indiana, Indianapolis, IN, USA.
Neurorehabil Neural Repair. 2020 Jul;34(7):652-660. doi: 10.1177/1545968320929675. Epub 2020 Jun 6.
. Previous studies suggest that individuals poststroke can achieve substantial gains in walking function following high-intensity locomotor training (LT). Recent findings also indicate practice of variable stepping tasks targeting locomotor deficits can mitigate selected impairments underlying reduced walking speeds. The goal of this study was to investigate alterations in locomotor biomechanics following 3 different LT paradigms. . This secondary analysis of a randomized trial recruited individuals 18 to 85 years old and >6 months poststroke. We compared changes in spatiotemporal, joint kinematics, and kinetics following up to 30 sessions of high-intensity (>70% heart rate reserve [HRR]) LT of variable tasks targeting paretic limb and balance impairments (high-variable, HV), high-intensity LT focused only on forward walking (high-forward, HF), or low-intensity LT (<40% HRR) of variable tasks (low-variable, LV). Sagittal spatiotemporal and joint kinematics, and concentric joint powers were compared between groups. Regressions and principal component analyses were conducted to evaluate relative contributions or importance of biomechanical changes to between and within groups. . Biomechanical data were available on 50 participants who could walk ≥0.1 m/s on a motorized treadmill. Significant differences in spatiotemporal parameters, kinematic consistency, and kinetics were observed between HV and HF versus LV. Resultant principal component analyses were characterized by paretic powers and kinematic consistency following HV, while HF and LV were characterized by nonparetic powers. . High-intensity LT results in greater changes in kinematics and kinetics as compared with lower-intensity interventions. The results may suggest greater paretic-limb contributions with high-intensity variable stepping training that targets specific biomechanical deficits. . https://clinicaltrials.gov/ Unique Identifier: NCT02507466.
. 先前的研究表明，个体在经历高强度的运动训练（LT）后，在行走功能上可以取得显著的进步。最近的研究结果也表明，针对运动缺陷进行可变步幅任务的练习，可以减轻导致行走速度降低的一些特定损伤。本研究的目的是调查 3 种不同 LT 模式对运动生物力学的改变。. 这是一项随机试验的二次分析，招募了 18 至 85 岁且中风后 >6 个月的个体。我们比较了 30 次高（>70%心率储备[HRR]）针对患侧和平衡损伤的可变任务 LT（高变，HV）、仅针对向前行走的高强度 LT（高前，HF）或低强度 LT（<40%HRR）（低变，LV）后，时空、关节运动学和动力学的变化。对组间的矢状时空和关节运动学以及向心关节功率进行了比较。回归和主成分分析用于评估生物力学变化对组间和组内的相对贡献或重要性。. 有 50 名参与者的生物力学数据可用于在电动跑步机上行走≥0.1 m/s。HV 和 HF 与 LV 相比，在时空参数、运动学一致性和动力学方面存在显著差异。主成分分析的结果表现为 HV 后患侧功率和运动学一致性，而 HF 和 LV 则表现为非患侧功率。. 与低强度干预相比，高强度 LT 会导致更大的运动学和动力学变化。结果可能表明，高强度可变步幅训练针对特定的生物力学缺陷，对患侧的贡献更大。. https://clinicaltrials.gov/ 独特标识符：NCT02507466。
