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渐进性桥式运动对卒中患者从坐到站伸展阶段负重及从坐到站能力的影响:一项随机对照试验。

Effect of progressive bridging exercise on weight-bearing during the extension phase of sit-to-stand, and on sit-to-stand ability in individuals with stroke: A randomised controlled trial.

作者信息

Pankheaw Thitinat, Hiengkaew Vimonwan, Bovonsunthonchai Sunee, Tretriluxana Jarugool

机构信息

Faculty of Physical Therapy, 26685Mahidol University, Salaya, Nakhon Pathom, Thailand.

出版信息

Clin Rehabil. 2022 Nov;36(11):1463-1475. doi: 10.1177/02692155221107107. Epub 2022 Jul 11.

Abstract

OBJECTIVE

To examine the effect of a progressive bridging exercise on force, time, and pressure during the extension phase of sit-to-stand, and on sit-to-stand ability in individuals with stroke.

DESIGN

A single-blinded randomised controlled trial.

SETTING

Hospital.

PARTICIPANTS

Forty-eight individuals with acute ischemic stroke, not at brainstem and cerebellum, randomly allocated to the intervention ( = 24) and control ( = 24) groups. Five participants dropped out during the 2-month follow-up, but they were in the intention-to-treat analysis.

INTERVENTIONS

The intervention group undertook a 45-min conventional physiotherapy and a 30-min progressive bridging exercise. The control group received only the conventional exercise.

MAIN MEASURES

Peak vertical ground reaction force, time to peak force, peak foot pressure, and regional peak foot pressure during the extension phase of sit-to-stand, and sitting-to-standing item of the Motor Assessment Scale were assessed before training, after 4-week training, and 2-month follow-up.

RESULTS

The intervention group showed significantly ( < 0.001) less difference in peak vertical ground reaction force between feet during the extension phase of sit-to-stand than the control after 4-week training (mean ± standard deviation; intervention, 5.38 ± 3.99; control, 17.1 ± 10.3) and 2-month follow-up (intervention, 6.79 ± 3.84; control, 17.5 ± 9.89), and demonstrated significantly ( < 0.001) higher score in sit-to-stand than the control after training [mean (interquartile range); intervention, 5 (2-5); control, 2 (1-2)] and follow-up [intervention, 2 (2-5); control, 2 (1-2)]. Both groups demonstrated peak foot pressure on the medial and lateral heels, metatarsals, and hallux regions.

CONCLUSION

Progressive bridging exercise improved symmetrical weight bearing during the extension phase of sit-to-stand, consequently enhanced sit-to-stand ability in individuals with stroke.

摘要

目的

研究渐进性搭桥运动对卒中患者从坐到站伸展阶段的力量、时间和压力,以及对其从坐到站能力的影响。

设计

单盲随机对照试验。

地点

医院。

参与者

48例急性缺血性卒中患者,病变不在脑干和小脑,随机分为干预组(n = 24)和对照组(n = 24)。5名参与者在2个月的随访期间退出,但纳入意向性分析。

干预措施

干预组进行45分钟的常规物理治疗和30分钟的渐进性搭桥运动。对照组仅接受常规运动。

主要测量指标

在训练前、4周训练后和2个月随访时,评估从坐到站伸展阶段的垂直地面峰值反作用力、达到峰值力的时间、峰值足压力和足部区域峰值压力,以及运动评估量表中的从坐到站项目。

结果

4周训练后(均值±标准差;干预组,5.38±3.99;对照组,17.1±10.3)和2个月随访时(干预组,6.79±3.84;对照组,17.5±9.89),干预组在从坐到站伸展阶段双脚之间的垂直地面峰值反作用力差异显著小于对照组(P < 0.001),且训练后(均值[四分位数间距];干预组,5[2 - 5];对照组,2[1 - 2])和随访时(干预组,2[2 - 5];对照组,2[1 - 2]),干预组从坐到站的得分显著高于对照组(P < 0.001)。两组在足跟内侧和外侧、跖骨和拇趾区域均出现峰值足压力。

结论

渐进性搭桥运动改善了从坐到站伸展阶段的对称负重,从而增强了卒中患者的从坐到站能力。

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