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一项旨在改善中风患者认知功能的远程医疗锻炼计划。

A telehealth exercise program to improve cognition in people with stroke.

作者信息

Thielman Gregory, Roos Margaret

机构信息

Department of Physical Therapy, Saint Joseph's University, 5600 City Avenue, Philadelphia, PA, 19131-1395, USA.

出版信息

Sci Rep. 2025 Jul 1;15(1):21109. doi: 10.1038/s41598-025-07064-9.

Abstract

Due to severe physical impairments and reduced mobility, post-stroke cognitive impairment is often not prioritized in the acute physical therapy rehabilitation phase. This creates a need for cognitive reinforcement to be prioritized later in rehabilitation. We investigated the benefits of a cognitive reinforcement training program using exercise and performed via telehealth in people with stroke, compared to healthy older adults. A pretest/posttest cross-sectional study design with Healthy older adults (HOA, n = 9), and subjects' post-stroke (SPS, n = 8participated in a telehealth physical therapist-led group exercise class set to music while seated, that included cognitive challenges, three times per week for five weeks. Each class involved full body strengthening with cognitive challenges (dual-tasking). Functional outcome measures performed were repeated using a dual-task paradigm. After 15 one-hour telehealth exercise sessions, the most significant results were the 2 Minute Walk Test (adjusted mean difference 18; 95% CI 204, 222) and 30 s Sit to Stand Test (30STS) (adjusted mean difference 4.2; 95% CI 10.6, 14.8) resulting in an intergroup main effect, with both groups improving (p < .013 and p < .002, respectively) in the standard task as well as when combined with a cognitive Verbal Fluency Test for the 30STS (adjusted mean difference 3; 95% CI 5.8, 8.8) (p < .002). In individuals with stroke, a telehealth exercise program, as described in this study, is safe and efficient in improving one's ability to perform daily functional activities with dual tasking.Clinical Trial Registration NCT05919251 (26-06-2023).

摘要

由于严重的身体损伤和活动能力下降,中风后认知障碍在急性物理治疗康复阶段往往未被列为优先事项。这就需要在康复后期将认知强化作为优先事项。我们调查了与健康老年人相比,中风患者通过远程医疗进行基于运动的认知强化训练计划的益处。采用了前测/后测横断面研究设计,健康老年人(HOA,n = 9)和中风后受试者(SPS,n = 8)参加了由物理治疗师通过远程医疗指导的、坐着进行的、配有音乐的小组运动课程,其中包括认知挑战,每周三次,共五周。每次课程都包括伴有认知挑战(双重任务)的全身强化训练。使用双重任务范式重复进行功能结果测量。在进行了15次一小时的远程医疗运动课程后,最显著的结果是2分钟步行测试(调整后平均差异18;95%置信区间204, 222)和30秒坐立测试(30STS)(调整后平均差异4.2;95%置信区间10.6, 14.8),产生了组间主效应,两组在标准任务以及与30STS的认知言语流畅性测试相结合时均有改善(分别为p <.013和p <.002)(调整后平均差异3;95%置信区间5.8, 8.8)(p <.002)。在中风患者中,本研究中描述的远程医疗运动计划在提高双重任务下进行日常功能活动的能力方面是安全且有效的。临床试验注册号NCT05919251(2023年6月26日)。

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