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有或没有有氧运动的任务练习可改善中风后与健康相关的生活质量和社会参与度:一项随机临床试验。

Task Practice With and Without Aerobic Exercise Improves Health-related Quality of Life and Social Participation Post-stroke: A Randomized Clinical Trial.

作者信息

Linder Susan M, Bischof-Bockbrader Andrea, Ince Hocaoglu Ozlenen Eylul, Bethoux Francois, Davidson Sara, Harris Donayja, Li Yadi, Lapin Brittany, Alberts Jay L

机构信息

Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Cleveland, OH, USA.

Cleveland Clinic, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, OH, USA.

出版信息

Neurorehabil Neural Repair. 2025 Aug;39(8):591-601. doi: 10.1177/15459683251338784. Epub 2025 May 22.

Abstract

BACKGROUND

Physical, cognitive, and psychosocial impairments experienced by individuals post-stroke detrimentally impact health-related quality of life (HRQoL). Rehabilitation interventions targeting the recovery of motor function aim to improve community reintegration and HRQoL. Aerobic exercise has also been shown to have global effects in individuals post-stroke, positively affecting motor and mood-related outcomes.

OBJECTIVE

To determine the effects of forced-rate aerobic exercise (FE) coupled with upper extremity repetitive task practice (RTP) on HRQoL and mood in individuals post-stroke.

METHODS

A rater blinded randomized clinical trial was conducted. Individuals ≥6 months post-stroke received 90-minute sessions of FE+RTP or time-matched RTP alone, 3×/week for 8 weeks. The Stroke Impact Scale (SIS), Patient-Reported Outcomes Measurement Information System (PROMIS-29), and Centers For Epidemiology Studies-Depression Scale (CES-D) were administered at baseline, end of treatment (EOT), EOT+6 months, and EOT+12 months.

RESULTS

Sixty participants enrolled in the study and 57 completed the self-reported questionnaires (FE + RTP, N = 29; RTP alone, N = 28). Both groups improved significantly at each time point in the following SIS domains: physical problems, feelings, activities of daily living, mobility, hand use, meaningful activities, and overall recovery; and in the participation domain of PROMIS-29. Depressive symptomology as measured by CES-D improved from baseline to EOT+6. There were no significant group differences in any of the outcomes.

CONCLUSIONS

Both interventions were comparably effective in improving HRQoL despite the FE+RTP group receiving only half the dose of RTP compared to the control group (RTP only). Improvements were maintained up to 1 year post-intervention.

摘要

背景

中风后个体所经历的身体、认知和心理社会障碍对健康相关生活质量(HRQoL)产生不利影响。针对运动功能恢复的康复干预旨在改善社区融入和HRQoL。有氧运动也已被证明对中风后个体具有全面影响,对运动和情绪相关结果产生积极影响。

目的

确定强制速率有氧运动(FE)结合上肢重复性任务练习(RTP)对中风后个体HRQoL和情绪的影响。

方法

进行了一项评估者盲法随机临床试验。中风后≥6个月的个体接受90分钟的FE+RTP或仅时间匹配的RTP治疗,每周3次,共8周。在基线、治疗结束(EOT)、EOT+6个月和EOT+12个月时使用中风影响量表(SIS)、患者报告结局测量信息系统(PROMIS-29)和流行病学研究中心抑郁量表(CES-D)进行评估。

结果

60名参与者纳入研究,57名完成了自我报告问卷(FE+RTP组,N=29;仅RTP组,N=28)。两组在以下SIS领域的每个时间点均有显著改善:身体问题、感觉、日常生活活动、 mobility、手部使用、有意义的活动和总体恢复;以及PROMIS-29的参与领域。CES-D测量的抑郁症状从基线到EOT+6有所改善。在任何结局中均无显著组间差异。

结论

尽管FE+RTP组与对照组(仅RTP)相比仅接受了一半剂量的RTP,但两种干预在改善HRQoL方面同样有效。干预后长达1年仍保持改善。

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