Jharbade Meenakshi, Ramachandran Sivakumar, V Shankar, Solomon M John
Department of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research. (Deemed to be University), Chennai, IND.
Department of Neurology, Sri Ramachandra Institute of Higher Education and Research. (Deemed to be University), Chennai, IND.
Cureus. 2024 Apr 11;16(4):e58087. doi: 10.7759/cureus.58087. eCollection 2024 Apr.
Engaging in meaningful and repetitive goal-oriented functional tasks can effectively enhance neuroplasticity and facilitate recovery following a stroke. This particular approach has primarily been studied in relation to functional outcomes and has predominantly focused on late subacute and chronic stroke patients. However, there is a lack of information regarding the standardized protocol of lower extremity functional training, its constituent elements, and its impact on motor recovery during the early subacute phase of stroke. The aim of this study was to examine the available evidence related to the intervention protocol of lower extremity functional training in order to identify common training elements and assess their impact on motor and functional outcomes in stroke survivors. A systematic search was conducted on PubMed and Scopus, covering the period from 2000 to 2022. A total of 1786 articles were retrieved and screened based on predefined inclusion criteria. A total of 36 articles were included in this review. The primary findings were classified into categories such as intervention protocols for functional training and their constituent elements, outcome measures utilized, minimal clinically important differences (MCID) reported, and the conclusions drawn by the respective studies. Only a limited quantity of studies reported on the intervention protocol of lower extremity functional training. The majority of these studies focused on the efficacy of functional training for enhancing gait and balance, as evaluated through functional outcome assessments, particularly in the context of chronic stroke patients. In most studies, the evaluation of outcomes was typically based on statistical significance rather than clinical significance. In light of these findings, it is recommended that future studies be conducted during the early subacute phase of stroke to further investigate the impact of functional training on motor outcomes. This will contribute to a broader understanding of the benefits of functional training in facilitating motor recovery in the lower extremities and its clinical significance in stroke survivors.
参与有意义且重复的目标导向性功能任务可以有效增强神经可塑性，并促进中风后的恢复。这种特定方法主要是针对功能结果进行研究的，并且主要集中在亚急性后期和慢性中风患者身上。然而，关于下肢功能训练的标准化方案、其组成要素以及在中风亚急性早期阶段对运动恢复的影响，目前缺乏相关信息。本研究的目的是检查与下肢功能训练干预方案相关的现有证据，以确定常见的训练要素，并评估它们对中风幸存者运动和功能结果的影响。我们在PubMed和Scopus上进行了系统检索，涵盖2000年至2022年期间。根据预先定义的纳入标准，共检索并筛选出1786篇文章。本综述共纳入36篇文章。主要研究结果分为功能训练干预方案及其组成要素、所采用的结果测量指标、报告的最小临床重要差异（MCID）以及各研究得出的结论等类别。只有少数研究报道了下肢功能训练的干预方案。这些研究大多关注功能训练对改善步态和平衡的疗效，通过功能结果评估进行评价，特别是在慢性中风患者的背景下。在大多数研究中，结果评估通常基于统计学意义而非临床意义。鉴于这些发现，建议在中风亚急性早期阶段开展进一步研究，以进一步调查功能训练对运动结果的影响。这将有助于更广泛地理解功能训练在促进下肢运动恢复方面的益处及其对中风幸存者的临床意义。
