Maeno Takashi, Matsumoto Izumi, Harada Kazuhiro
Department of Rehabilitation, Yuseikai Midorigaoka Hospital, Takatsuki, JPN.
Graduate School of Health Science Studies, Kibi International University, Takahashi, JPN.
Cureus. 2025 May 15;17(5):e84149. doi: 10.7759/cureus.84149. eCollection 2025 May.
Stroke and peripheral arterial disease (PAD) are common causes of impaired walking and reduced physical activity levels, both of which contribute to a decline in quality of life (QOL). Effective rehabilitation strategies that integrate functional training and physical activity management are essential for improving walking ability and QOL in patients with such multimorbidity. This case report describes a 70-year-old woman with left hemiparesis due to branch atheromatous disease and PAD (Fontaine stage IIb). She participated in a comprehensive rehabilitation program that combined functional training and physical activity management using a triaxial accelerometer. The intervention included strength training, treadmill walking, and balance exercises conducted seven days per week for 60-120 minutes per day, targeting a Borg scale rating of 13-15 for lower limb fatigue. Physical activity management focused on reducing sedentary behavior (SB) and increasing light-intensity physical activity (LPA) and daily step counts through goal setting and real-time feedback from the accelerometer. After 39 days, her six-minute walk distance increased to 190 meters, walking speed improved to 1.11 m/s, and initial claudication distance extended to 150 meters. Her daily step count rose to 3,204, LPA increased to 381 minutes per day, and SB decreased to 479 minutes per day. Health-related QOL, assessed using the Walking Impairment Questionnaire (WIQ) and the Vascular Quality of Life Questionnaire (VascuQOL), also showed marked improvement. This case suggests that intensive functional training combined with high-frequency physical activity management may be effective for improving mobility and QOL in patients with multimorbidity in convalescent rehabilitation wards.
中风和外周动脉疾病（PAD）是导致行走功能受损和身体活动水平降低的常见原因，这两者都会导致生活质量（QOL）下降。整合功能训练和身体活动管理的有效康复策略对于改善患有此类多种疾病的患者的行走能力和生活质量至关重要。本病例报告描述了一名70岁女性，因分支动脉粥样硬化疾病和PAD（Fontaine IIb期）导致左半身轻瘫。她参加了一项综合康复计划，该计划使用三轴加速度计将功能训练和身体活动管理相结合。干预措施包括每周七天、每天60 - 120分钟的力量训练、跑步机行走和平衡练习，目标是使下肢疲劳的Borg量表评分为13 - 15。身体活动管理侧重于通过设定目标和加速度计的实时反馈来减少久坐行为（SB），增加轻度身体活动（LPA）和每日步数。39天后，她的六分钟步行距离增加到190米，步行速度提高到1.11米/秒，初始跛行距离延长到150米。她的每日步数增加到3204步，LPA增加到每天381分钟，SB减少到每天479分钟。使用步行障碍问卷（WIQ）和血管生活质量问卷（VascuQOL）评估的与健康相关的生活质量也有显著改善。该病例表明，强化功能训练与高频身体活动管理相结合可能对改善康复病房中患有多种疾病的患者的活动能力和生活质量有效。
