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创新步态训练机改善慢性脑卒中幸存者步态:一项随机对照试验。

Gait Improvement in Chronic Stroke Survivors by Using an Innovative Gait Training Machine: A Randomized Controlled Trial.

机构信息

Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand.

Center of Excellence in Creative Engineering Design and Development, Thammasat University, Pathumthani 12120, Thailand.

出版信息

Int J Environ Res Public Health. 2021 Dec 25;19(1):224. doi: 10.3390/ijerph19010224.

Abstract

Chronic stroke leads to the impairment of lower limb function and gait performance. After in-hospital rehabilitation, most individuals lack continuous gait training because of the limited number of physical therapists. This study aimed to evaluate the effects of a newly invented gait training machine (I-Walk) on lower limb function and gait performance in chronic stroke individuals. Thirty community-dwelling chronic stroke individuals were allocated to the I-Walk machine group ( = 15) or the overground gait training (control) group ( = 15). Both groups received 30 min of upper limb and hand movement and sit-to-stand training. After that, the I-Walk group received 30 min of I-Walk training, while the control followed a 30-minute overground training program. All the individuals were trained 3 days/week for 8 weeks. The primary outcome of the motor recovery of lower limb impairment was measured using the Fugl-Meyer Assessment (FMA). The secondary outcomes for gait performance were the 6-minute walk test (6 MWT), the 10-meter walk test (10 MWT), and the Timed Up and Go (TUG). The two-way mixed-model ANOVA with the Bonferroni test was used to compare means within and between groups. The post-intervention motor and sensory subscales of the FMA significantly increased compared to the baseline in both groups. Moreover, the 6 MWT and 10 MWT values also improved in both groups. In addition, the mean difference of TUG in the I-Walk was higher than the control. The efficiency of I-Walk training was comparable to overground training and might be applied for chronic stroke gait training in the community.

摘要

慢性中风会导致下肢功能和步态表现受损。在住院康复后,由于物理治疗师人数有限,大多数患者缺乏持续的步态训练。本研究旨在评估新型步态训练机(I-Walk)对慢性中风患者下肢功能和步态表现的影响。30 名居住在社区的慢性中风患者被分配到 I-Walk 机器组(n=15)或地面步态训练(对照组)(n=15)。两组均接受 30 分钟的上肢和手部运动以及坐-站训练。之后,I-Walk 组接受 30 分钟的 I-Walk 训练,而对照组则进行 30 分钟的地面训练。所有患者每周训练 3 天,共 8 周。下肢损伤运动恢复的主要结果采用 Fugl-Meyer 评估(FMA)进行测量。步态表现的次要结果包括 6 分钟步行测试(6 MWT)、10 米步行测试(10 MWT)和计时起立行走测试(TUG)。采用双向混合模型方差分析和 Bonferroni 检验比较组内和组间的平均值。与基线相比,两组的 FMA 运动和感觉子量表在干预后均显著增加。此外,两组的 6 MWT 和 10 MWT 值也有所改善。此外,I-Walk 组的 TUG 平均值差异高于对照组。I-Walk 训练的效率与地面训练相当,可能适用于社区中的慢性中风步态训练。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccab/8750435/04273e838afa/ijerph-19-00224-g001.jpg

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