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随机对照试验:高强度跑步机步态训练对创伤性脑损伤患者恢复影响的初步调查

Randomized Controlled Trial: Preliminary Investigation of the Impact of High-Intensity Treadmill Gait Training on Recovery Among Persons with Traumatic Brain Injury.

作者信息

Shick Tyler, Perkins Courtney, Paul Arco, Martinez Melissa, Joyce Joseph, Beach Katy, Swahlan Jeffrey, Weppner Justin

机构信息

Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.

Carilion Clinic, Roanoke, Virginia, USA.

出版信息

Neurotrauma Rep. 2025 Jan 24;6(1):82-92. doi: 10.1089/neur.2024.0169. eCollection 2025.

DOI:10.1089/neur.2024.0169
PMID:39882311
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11773168/
Abstract

Exercise to treat traumatic brain injury (TBI) is a novel approach that has only become recognized in the past decade. High-intensity gait training (HIGT) has been studied in subjects following stroke; however, little research investigates similar protocols on patients with TBI. The study evaluated HIGT as an intervention for enhancing patient recovery after TBI. Adult subjects (18-65 years) who suffered TBI were randomly allocated to an intervention (HIGT) or control (low-intensity physical therapy) group given three days/week for 1 h over four weeks. Assessments included the 10-m walk test, 6-min walk test, Berg Balance Scale, five-times sit-to-stand (5TSTS), timed up and go (TUG), cognitive TUG, and Montreal Cognitive Assessment (MoCA) at day one, two weeks, four weeks, and a four-week follow-up. In addition to a trend toward improved gait speed ( < 0.1) and significantly improved endurance ( < 0.05) in the HIGT group ( = 5), both the control ( = 4) and HIGT groups demonstrated trends toward improved mobility (5TSTS, < 0.1; TUG, < 0.1) and significantly improved cognition (cognitive TUG, < 0.01; MoCA, < 0.05) over the four-week time period and at the one-month follow-up. HIGT showed longer-lasting rehabilitative effects on gait distance, endurance, mobility, and cognitive function at the four-week follow-up. This study suggests that HIGT may support functional recovery, and future work will involve increasing sample size.

摘要

运动疗法治疗创伤性脑损伤(TBI)是一种新方法,在过去十年才开始受到认可。高强度步态训练(HIGT)已在中风患者中进行了研究;然而,很少有研究调查针对TBI患者的类似方案。该研究评估了HIGT作为一种促进TBI患者康复的干预措施。将成年TBI患者(18 - 65岁)随机分配到干预组(HIGT)或对照组(低强度物理治疗),每周进行三天,每次1小时,共四周。评估包括第1天、第2周、第4周以及四周随访时的10米步行测试、6分钟步行测试、伯格平衡量表、五次坐立试验(5TSTS)、计时起立行走测试(TUG)、认知TUG和蒙特利尔认知评估(MoCA)。除了HIGT组(n = 5)有步态速度改善趋势(P < 0.1)和耐力显著改善(P < 0.05)外,对照组(n = 4)和HIGT组在四周期间和一个月随访时均有移动能力改善趋势(5TSTS,P < 0.1;TUG,P < 0.1)以及认知能力显著改善(认知TUG,P < 0.01;MoCA,P < 0.05)。在四周随访时,HIGT对步态距离、耐力、移动能力和认知功能显示出更持久的康复效果。这项研究表明HIGT可能有助于功能恢复,未来的工作将包括增加样本量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/528d8c89f269/neur.2024.0169_figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/5e3264cfffa1/neur.2024.0169_figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/91b175c07ad5/neur.2024.0169_figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/ed208271dedb/neur.2024.0169_figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/528d8c89f269/neur.2024.0169_figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/5e3264cfffa1/neur.2024.0169_figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/91b175c07ad5/neur.2024.0169_figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/ed208271dedb/neur.2024.0169_figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0047/11773168/528d8c89f269/neur.2024.0169_figure4.jpg

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本文引用的文献

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Moderate Intensity Treadmill Exercise Increases Survival of Newborn Hippocampal Neurons and Improves Neurobehavioral Outcomes after Traumatic Brain Injury.
中强度跑步机运动可增加新生海马神经元的存活率,并改善创伤性脑损伤后的神经行为结局。
J Neurotrauma. 2021 Jun 1;38(13):1858-1869. doi: 10.1089/neu.2020.7389. Epub 2021 Feb 10.
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Implementation of High-Intensity Stepping Training During Inpatient Stroke Rehabilitation Improves Functional Outcomes.高强度踏步训练在住院脑卒中康复中的实施改善了功能结局。
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