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中风患者下肢等速肌力训练:随机对照试验的系统评价

Isokinetic Muscle Strengthening of the Lower Limbs in People with Stroke: A Systematic Review of Randomized Controlled Trials.

作者信息

Aguirre-Villanueva Elsa Alejandra, Cano-de-la-Cuerda Roberto, Laguarta-Val Sofía

机构信息

Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Alcorcón, Spain.

出版信息

J Clin Med. 2025 Mar 25;14(7):2215. doi: 10.3390/jcm14072215.

Abstract

Muscle weakness is one of the main consequences following a stroke, leading to significant alterations in gait and other daily activities. Isokinetic muscle strengthening of the lower limb is considered to be an effective complement to conventional treatment to improve these functional limitations. The objective of this systematic review was to analyze isokinetic lower limb strengthening protocols and their effects on muscle strength, gait, and mobility in post-stroke patients compared to conventional physiotherapy or other strengthening methods. A systematic review of randomized controlled trials (RCTs) from the last 10 years was conducted. Studies analyzing the effects of isokinetic lower limb muscle strengthening compared to conventional physiotherapy or other strengthening methods on muscle strength, gait parameters, and mobility in post-stroke adults were selected. The quality and risk of bias of the studies were evaluated using the PEDro scale, the Oxford Level of Evidence scale, and the Cochrane Review Manager tool. Six studies met the eligibility criteria. For knee-ankle strength, gait speed, and mobility, isokinetic strengthening demonstrated significant improvements compared to conventional physical therapy. When compared to other strengthening methods, isokinetic training was more effective for hip-knee strength and mobility, while closed kinetic chain isokinetic strengthening showed greater benefits for gait speed. Additionally, in the early post-stroke phase, isokinetic training showed greater improvements, while the chronic phase demonstrated more variable results. The methodological quality of the studies was acceptable-good. Isokinetic muscle strengthening significantly improves muscle strength, gait speed, and mobility in post-stroke adults compared to conventional physical therapy, offering additional benefits over other strengthening methods. Further research is needed to evaluate its long-term effectiveness, optimize protocols, and explore the impact of treatment timing.

摘要

肌肉无力是中风后的主要后果之一,会导致步态和其他日常活动出现显著改变。下肢等速肌力训练被认为是改善这些功能受限的传统治疗的有效补充。本系统评价的目的是分析与传统物理治疗或其他强化方法相比,等速下肢强化训练方案及其对中风后患者肌肉力量、步态和活动能力的影响。对过去10年的随机对照试验(RCT)进行了系统评价。选择分析与传统物理治疗或其他强化方法相比,等速下肢肌肉强化训练对中风后成年人肌肉力量、步态参数和活动能力影响的研究。使用PEDro量表、牛津证据水平量表和Cochrane综述管理器工具评估研究的质量和偏倚风险。六项研究符合纳入标准。在膝关节-踝关节力量、步速和活动能力方面,与传统物理治疗相比,等速强化训练显示出显著改善。与其他强化方法相比,等速训练对髋-膝关节力量和活动能力更有效,而闭链等速强化训练对步速的益处更大。此外,在中风后早期阶段,等速训练显示出更大的改善,而慢性期的结果则更具变异性。研究的方法学质量为可接受-良好。与传统物理治疗相比,等速肌肉强化训练显著改善了中风后成年人的肌肉力量、步速和活动能力,比其他强化方法具有更多益处。需要进一步研究来评估其长期有效性、优化训练方案,并探索治疗时机的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2c7/11989997/989f7027812c/jcm-14-02215-g001.jpg

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