Marklund Ingela, Fure Brynjar, Klässbo Maria, Liv Per, Stålnacke Britt-Marie, Hu Xiaolei
Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden.
PLoS One. 2025 May 8;20(5):e0323290. doi: 10.1371/journal.pone.0323290. eCollection 2025.
Lower- extremity constraint-induced movement therapy (LE-CIMT) has proven effective in overcoming physical disabilities. Participating in the LE-CIMT requires some independent walking ability without aids that indicates a higher level of motor function than for the entire stroke population. However, only few studies evaluated health-related quality of life (HRQoL) after LE-CIMT. This study aimed to compare HRQoL of people who had participated in LE-CIMT post-stroke to the general population and evaluate whether descriptive characteristics and clinical result were associated with their HRQoL. An observational survey study with a questionnaire including the Swedish RAND-36 and Saltin-Grimby Physical Activity Level Scale was sent to 162 people. Reference data from the Mid-Health Survey in Sweden was used for norm-based comparisons of RAND-36. Respondents' result from six-minute walk test post-LE-CIMT were used in the univariate analyse. The response rate was 65% (n = 106; 69 males and 37 females with a mean age of 62 ± 12 years). Ninety percent of the respondents could move around indoors and outdoors independently, despite this, 21% considered themselves physically inactive. The respondents had significantly reduced HRQoL compared to the general population in four of eight domains in the RAND-36: physical functioning (p = 0.001), role-functioning (physical; p < 0.001), general health (p = 0.010), and social functioning (p < 0.001). Regression analysis showed that longer walking distance significantly was associated with the RAND-36 physical functioning domain (β = 6.45, 95% confidence interval = 2.03-10.87, p = 0.005). People in the chronic phase post-stroke who had previously participated in LE- CIMT had reduced HRQoL compared to the general population regarding physical functioning, role-functioning physical, general health, and social functioning. A longer walking distance was associated with higher HRQoL in physical functioning domain, emphasising the importance of mobility training in post-stroke rehabilitation.
下肢强制性运动疗法(LE-CIMT)已被证明在克服身体残疾方面有效。参与LE-CIMT需要一定的独立行走能力,无需辅助,这表明其运动功能水平高于整个中风人群。然而,只有少数研究评估了LE-CIMT后的健康相关生活质量(HRQoL)。本研究旨在比较中风后参与LE-CIMT的人群与一般人群的HRQoL,并评估描述性特征和临床结果是否与他们的HRQoL相关。一项观察性调查研究向162人发送了包含瑞典RAND-36和萨尔廷-格林比身体活动水平量表的问卷。瑞典中年健康调查的参考数据用于基于规范的RAND-36比较。LE-CIMT后六分钟步行测试的受访者结果用于单变量分析。回复率为65%(n = 106;69名男性和37名女性,平均年龄62±12岁)。90%的受访者能够在室内和室外独立活动,尽管如此,21%的人认为自己身体不活跃。在RAND-36的八个领域中的四个领域,受访者的HRQoL与一般人群相比显著降低:身体功能(p = 0.001)、角色功能(身体;p < 0.001)、总体健康(p = 0.010)和社会功能(p < 0.001)。回归分析表明,更长的步行距离与RAND-36身体功能领域显著相关(β = 6.45,95%置信区间 = 2.03 - 10.87,p = 0.005)。与一般人群相比,中风后慢性期曾参与LE-CIMT的人群在身体功能、角色功能(身体)、总体健康和社会功能方面的HRQoL降低。更长的步行距离与身体功能领域更高的HRQoL相关,强调了运动训练在中风后康复中的重要性。