Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America.
Department of Kinesiology, Division of Education, Human Development, and Social Sciences, Pennsylvania State University Altoona, Altoona, PA, United States of America.
Prog Cardiovasc Dis. 2021 Jan-Feb;64:83-87. doi: 10.1016/j.pcad.2020.12.003. Epub 2020 Dec 24.
Increasing daily steps is important to maintain health and prevent both initial and subsequent cardiovascular (CV) disease (CVD) events. Even 5000 steps have been associated with reduced risk of CVD, however many adults and those with CVD walk fewer than 5000 daily steps. Reduced gait speed is a precursor to decreased physical engagement and is associated with biomarker changes linked to higher risk of CVD. Gait speed is decreased in those with CVD, which may be from changes in biomechanics including reduced step length and increased gait variability. Changes in gait and daily steps are often most discernable post-stroke, which may be from limitations of the CV system in meeting the metabolic demands of walking and the nervous system in exciting motoneuron pools to generate muscle force. This leads to gait asymmetries and decreased speed. Information regarding the effects of rehabilitation interventions (e.g., physical therapy) to increase physical activity (PA) in stroke survivors is limited. Current interventions include high intensity gait training and ischemic conditioning to improve walking speed and fatigability. Given the potential benefits of increased PA and daily steps following stroke, there is a need for more research investigating optimal dosage of daily steps and interventions to improve PA.
增加日常步数对于保持健康和预防初始和后续心血管疾病 (CVD) 事件很重要。即使每天走 5000 步也与降低 CVD 风险有关，但许多成年人和 CVD 患者每天走的步数都少于 5000 步。步速降低是身体活动减少的前兆，与与 CVD 风险较高相关的生物标志物变化有关。CVD 患者的步速降低，这可能是由于生物力学变化引起的，包括步长减少和步态变异性增加。步态和日常步数的变化在中风后通常最为明显，这可能是由于心血管系统无法满足行走的代谢需求，以及神经系统无法兴奋运动神经元池以产生肌肉力量。这导致步态不对称和速度降低。关于康复干预措施（例如物理治疗）增加中风幸存者身体活动 (PA) 的效果的信息有限。目前的干预措施包括高强度步态训练和缺血预处理以提高步行速度和疲劳性。鉴于中风后增加 PA 和日常步数的潜在好处，需要更多研究来调查改善 PA 的最佳日常步数和干预措施的剂量。
