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高强度间歇训练对脑卒中后身体和认知功能的影响:一项多中心随机对照试验。

Effects of High-Intensity Interval Training After Stroke (The HIIT Stroke Study) on Physical and Cognitive Function: A Multicenter Randomized Controlled Trial.

机构信息

Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim; Department of Physical Medicine and Rehabilitation, St Olav's Hospital, The University Hospital in Trondheim, Trondheim.

Department of Research, Sunnaas Rehabilitation Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo.

出版信息

Arch Phys Med Rehabil. 2021 Sep;102(9):1683-1691. doi: 10.1016/j.apmr.2021.05.008. Epub 2021 Jun 6.

Abstract

OBJECTIVE

To assess the effects of high-intensity interval training (HIIT) on physical, mental, and cognitive functioning after stroke.

DESIGN

The HIIT Stroke Study was a single-blind, multicenter, parallel-group randomized controlled trial.

SETTING

Specialized rehabilitation units at 3 Norwegian hospitals.

PARTICIPANTS

Adult stroke survivors (N=70) 3 months to 5 years after a first-ever stroke. Mean age was 57.6±9.2 years and 58.7±9.2 years in the intervention and control groups, respectively.

INTERVENTIONS

Participants were randomized to standard care in combination with 4×4 minutes of treadmill HIIT at 85%-95% of peak heart rate or standard care only.

OUTCOMES

Outcomes were measured using physical, mental, and cognitive tests and the FIM and Stroke Impact Scale. Linear mixed models were used to analyze differences between groups at posttest and 12-month follow-up.

RESULTS

The intervention group showed a significant treatment effect (95% confidence interval [CI]) from baseline to posttest on a 6-minute walk test of 28.3 (CI, 2.80-53.77) meters (P=.030); Berg Balance Scale 1.27 (CI, 0.17-2.28) points (P=.025); and Trail Making Test Part B (TMT-B; -24.16 [CI, -46.35 to -1.98] s, P=.033). The intervention group showed significantly greater improvement on TMT-B at the 12-month follow-up (25.44 [CI, -49.01 to -1.87] s, P=.035). The control group showed significantly greater improvement in total Functional Independence Measure score with a treatment effect of -2.37 (CI, -4.30 to -0.44) points (P=.016) at 12-month follow-up. No significant differences were identified between groups on other outcomes at any time point.

CONCLUSIONS

HIIT combined with standard care improved walking distance, balance, and executive function immediately after the intervention compared with standard care only. However, only TMT-B remained significant at the 12-month follow-up.

摘要

目的

评估高强度间歇训练(HIIT)对中风后身体、心理和认知功能的影响。

设计

HIIT 中风研究是一项单盲、多中心、平行组随机对照试验。

地点

挪威 3 家医院的专门康复单位。

参与者

中风后 3 个月至 5 年的成年中风幸存者(N=70)。干预组和对照组的平均年龄分别为 57.6±9.2 岁和 58.7±9.2 岁。

干预

参与者随机分为标准护理加 4×4 分钟跑步机 HIIT,强度为峰值心率的 85%-95%,或仅接受标准护理。

结果

使用身体、心理和认知测试以及 FIM 和中风影响量表来测量结果。线性混合模型用于分析组间在测试后和 12 个月随访时的差异。

结果

干预组在 6 分钟步行测试中从基线到测试后的治疗效果(95%置信区间 [CI])显著增加了 28.3(CI,2.80-53.77)米(P=.030);Berg 平衡量表增加 1.27(CI,0.17-2.28)分(P=.025);和 Trail Making Test 部分 B(TMT-B;-24.16 [CI,-46.35 至-1.98] s,P=.033)。干预组在 12 个月随访时 TMT-B 的改善更为显著(-25.44 [CI,-49.01 至-1.87] s,P=.035)。对照组在总功能性独立测量评分上的治疗效果为-2.37(CI,-4.30 至-0.44)分,在 12 个月随访时差异显著(P=.016)。在任何时间点,两组在其他结果上均无显著差异。

结论

与仅接受标准护理相比,HIIT 与标准护理相结合可立即改善步行距离、平衡和执行功能。然而,只有 TMT-B 在 12 个月随访时仍然显著。

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