Lee Jung-Lim, Ko Sung-Hwa, Huh Sungchul, Jung Jong-Chul, Kim Soo-Yong, Bae Dong-Yun, Shin Yong-Il, Kim Yuna
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea.
Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea.
Healthcare (Basel). 2024 Nov 15;12(22):2281. doi: 10.3390/healthcare12222281.
Stroke is a leading cause of mortality and long-term disability worldwide, often resulting in low levels of physical activity post-discharge. A comprehensive exercise program could be a safe method to increase stroke patients' physical activity and exercise volume. This pilot study examines the effectiveness, safety, and feasibility of a comprehensive exercise regimen for stroke patients residing in the community after discharge.
This single-group pilot study included patients who received inpatient rehabilitation for motor impairment following a stroke. Community-dwelling participants engaged in a comprehensive exercise program, which was structured and individualized, consisting of stretching, aerobic exercise, strength training, and balance exercises, conducted under the supervision of a health exercise specialist in a dedicated living lab within the hospital. The program involved 20 sessions, each lasting 50 min, conducted three to five times weekly. The pre- and post-intervention evaluations were comprehensive, including safety and validity assessments, along with physical function tests such as cardiopulmonary exercise testing and various fitness tests (6 min walk test, timed up and go test, chair stand test, figure-of-8 walk test, grip strength test, and sit-and-reach test). Depression levels were assessed using the Geriatric Depression Scale (GDS).
A total of 22 subjects were recruited, with 21 completing the study after one dropout due to fatigue and visiting distance. Among the 21 completers, one subject experienced a mild adverse event (hypoglycemia), which was not serious, confirming the program's safety. The exercise participation rate was 95.5%, and the adherence rate averaged 95.2%, with all completers achieving over 80% adherence. Significant improvements were observed in VO peak ( = 0.000), 6 min walk test ( = 0.000), timed up and go test ( = 0.000), chair stand test ( = 0.000), figure-of-8 walk test ( = 0.000), and grip strength ( = 0.001). However, changes in the peak respiratory exchange ratio ( = 0.078), sit-and-reach test ( = 0.228) and GDS scores ( = 0.275) were not significant.
This study demonstrates that the comprehensive exercise program is sufficiently safe and valid for stroke rehabilitation patients. The program significantly enhances cardiopulmonary endurance, walking ability, balance, muscle strength, muscle endurance, and coordination. Further research with larger sample sizes and control groups is needed to confirm these findings and explore additional benefits.
中风是全球范围内导致死亡和长期残疾的主要原因，常常导致患者出院后身体活动水平较低。一项全面的运动计划可能是增加中风患者身体活动和运动量的安全方法。这项试点研究考察了针对出院后居住在社区的中风患者的全面运动方案的有效性、安全性和可行性。
这项单组试点研究纳入了中风后因运动障碍接受住院康复治疗的患者。居住在社区的参与者参与了一项全面的运动计划，该计划是结构化且个性化的，包括伸展运动、有氧运动、力量训练和平衡练习，在医院内一个专门的生活实验室中由健康运动专家监督进行。该计划包括20节课程，每节持续50分钟，每周进行三到五次。干预前后的评估是全面的，包括安全性和有效性评估，以及心肺运动测试和各种体能测试（6分钟步行测试、计时起立行走测试、椅子站立测试、8字形步行测试、握力测试和坐位体前屈测试）等身体功能测试。使用老年抑郁量表（GDS）评估抑郁水平。
共招募了22名受试者，其中21名在1名因疲劳和路途遥远退出后完成了研究。在21名完成者中，1名受试者经历了一次轻微不良事件（低血糖），但不严重，证实了该计划的安全性。运动参与率为95.5%，依从率平均为95.2%，所有完成者的依从率均超过80%。观察到VO峰值（ = 0.000）、6分钟步行测试（ = 0.000）、计时起立行走测试（ = 0.000）、椅子站立测试（ = 0.000）、8字形步行测试（ = 0.000）和握力（ = 0.001）有显著改善。然而，峰值呼吸交换率（ = 0.078）、坐位体前屈测试（ = 0.228）和GDS评分（ = 0.275）的变化不显著。
本研究表明，全面运动计划对中风康复患者足够安全且有效。该计划显著提高了心肺耐力、步行能力、平衡、肌肉力量、肌肉耐力和协调性。需要进行更大样本量和有对照组的进一步研究来证实这些发现并探索其他益处。
