Afridi Ayesha, Malik Arshad Nawaz, Rathore Farooq Azam
Riphah International University, Islamabad, Pakistan.
Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan.
Physiother Res Int. 2025 Apr;30(2):e70064. doi: 10.1002/pri.70064.
Stroke often leads to long-term disability, impacting motor function, mobility, and quality of life. However, the effectiveness of different intensities of functional training in improving these outcomes in stroke rehabilitation is not well established.
This study aimed to determine the effects of different intensities of functional activities specific training on upper extremity function, mobility, fall risk, and quality of life in stroke patients.
This randomized controlled trial was conducted in a rehabilitation setting (PRH Islamabad) with age 40-60 years and 3 months post-stroke. Participants (N = 99) were randomly (simple) assigned to conventional therapy, moderate-intensity, or high-intensity training with 33 in each group. Eligibility criteria included a Montreal Cognitive Assessment score of 18-25, Fugl-Meyer Assessment score of 50-70 and a Modified Rankin Scale score of 3 and 4, suggesting moderate motor impairment and moderate to severe disability, respectively. Participants with severe spasticity, inability to follow two-step commands, concurrent stroke treatments, other neurological conditions, and a history of falls were excluded. The 12-week training program utilized the FAST-Table, and outcomes including Fugl-Meyer Assessment for upper extremity, Berg Balance Scale, and Stroke-Specific Quality of Life Urdu scale-were assessed at baseline, 4, 8, and 12 weeks.
The mean age of participants were 65.4 ± 7.2 years, gender (52% male, 48% female, ischemic 70%, and hemorrhagic 30%). The high-intensity group showed significant improvements in Fugl-Meyer Assessment-Upper Extremity scores at weeks 8 and 12 (p < 0.05), Timed Up and Go test (p < 0.05), Berg Balance Scale scores (p < 0.05), and Stroke-Specific Quality of Life Urdu scale (p < 0.05). Moderate-intensity and conventional groups also showed improvements individually.
High-intensity functional training leads to greater improvements in physical performance and quality of life in stroke survivors compared with moderate-intensity functional training and conventional therapies.
https://clinicaltrials.gov/ (NCT05158543).
中风常导致长期残疾，影响运动功能、活动能力和生活质量。然而，不同强度的功能训练在改善中风康复这些结局方面的有效性尚未明确。
本研究旨在确定不同强度的特定功能活动训练对中风患者上肢功能、活动能力、跌倒风险和生活质量的影响。
本随机对照试验在一家康复机构（伊斯兰堡巴基斯坦康复医院）进行，研究对象为年龄在40 - 60岁且中风后3个月的患者。参与者（N = 99）被随机（简单随机）分为常规治疗组、中等强度训练组或高强度训练组，每组33人。纳入标准包括蒙特利尔认知评估得分18 - 25分、Fugl - Meyer评估得分50 - 70分以及改良Rankin量表得分3分和4分，分别提示中度运动障碍和中度至重度残疾。排除有严重痉挛、无法听从两步指令、同时进行中风治疗、其他神经系统疾病以及有跌倒史的参与者。为期12周的训练计划使用了FAST - Table，在基线、第4周、第8周和第12周评估包括上肢Fugl - Meyer评估、伯格平衡量表和中风特异性生活质量乌尔都语量表等结局指标。
参与者的平均年龄为65.4 ± 7.2岁，性别分布为（男性52%，女性48%，缺血性中风70%，出血性中风30%）。高强度训练组在第8周和第12周的Fugl - Meyer评估上肢得分（p < 0.05）、计时起立行走测试（p < 0.05）、伯格平衡量表得分（p < 0.05）以及中风特异性生活质量乌尔都语量表（p < 0.05）方面有显著改善。中等强度训练组和常规治疗组也各自有所改善。
与中等强度功能训练和常规治疗相比，高强度功能训练能使中风幸存者的身体表现和生活质量得到更大改善。
