Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France.
Limoges university, HAVAE laboratory, EA 6310, 123, avenue Albert-Thomas, 87060 Limoges, France.
Ann Phys Rehabil Med. 2021 Jul;64(4):101453. doi: 10.1016/j.rehab.2020.11.001. Epub 2020 Nov 28.
The gains in walking capacity achieved during rehabilitation often plateau, or are lost, when the patient returns home. Moreover, maintaining or increasing the patient's daily physical activity level after a stroke remains challenging. We aimed to evaluate the effectiveness of a six-month individualized coaching program at home on walking capacity, as evaluated by the six-minute walk test in subacute stroke patients.
Stroke patients in the physical medicine and rehabilitation service participated in a monocentric observer blinded randomized controlled trial with two groups, intervention versus usual care control. The inclusion criteria were: age≥18 years, first ischemic or hemorrhagic stroke, and stroke within<6 months. Participants were randomly assigned (blocks of variable size) to an intervention group (EG) receiving individualized coaching on physical activity, or to a control group (CG) receiving standard care. The six-month program was composed of monitored physical activity, home visits and a weekly phone call. Participants were evaluated after hospital discharge (T0), at the end of the six-month program (T1) and six months later(follow-up; T2). The primary outcome was the walking distance performance, as evaluated with the six-minute walk test at T1.
Eighty-three participants (age: 61y [IQR=22]; time post-stroke: 2.4 month [IQR=1.7]; Barthel index: 100[IQR=5]) were included in the study: (EG, n=41; CG, n=42). The difference between the two groups was not significant at T1(418m [IQR=165] for the EG and 389m [IQR=188] for the CG; P=0.168) and at T2(425m [IQR=121] for the EG vs. 382m [IQR=219] for the CG; P=0.208).
Our study shows no difference in the six-minute walk test between the two groups of subacute stroke patients after 6 months of the individualized coaching program, combining home visits, feedback on daily performance and weekly telephone calls. http://ClinicalTrials.gov (NCT01822938).
患者康复期间行走能力的提高往往会达到平台期，或者在患者返回家中后会失去这些能力。此外，在中风后保持或增加患者的日常身体活动水平仍然具有挑战性。我们旨在评估在家进行为期六个月的个性化辅导计划对亚急性中风患者行走能力的影响，使用六分钟步行测试进行评估。
参加物理医学和康复服务的中风患者参与了一项单中心观察者盲随机对照试验，分为两组，干预组与常规护理对照组。纳入标准为：年龄≥18 岁，首次缺血性或出血性中风，中风时间<6 个月。参与者被随机分配（大小可变的块）到干预组（EG），接受身体活动的个性化辅导，或到对照组（CG），接受标准护理。为期六个月的计划包括监测身体活动、家访和每周电话。参与者在出院后（T0）、六个月计划结束时（T1）和六个月后（随访；T2）进行评估。主要结果是 T1 时使用六分钟步行测试评估的行走距离表现。
83 名参与者（年龄：61 岁[IQR=22]；中风后时间：2.4 个月[IQR=1.7]；巴氏指数：100[IQR=5]）纳入了这项研究：（EG，n=41；CG，n=42）。两组在 T1 时（EG 为 418m[IQR=165]，CG 为 389m[IQR=188]；P=0.168）和 T2 时（EG 为 425m[IQR=121]，CG 为 382m[IQR=219]；P=0.208）之间没有显著差异。
我们的研究表明，在亚急性中风患者接受为期六个月的个性化辅导计划后，包括家访、日常表现反馈和每周电话，两组之间的六分钟步行测试没有差异。http://ClinicalTrials.gov（NCT01822938）。
