McCartney Kiersten M, Boyne Pierce, Pohlig Ryan, Morton Susanne M, Reisman Darcy S
Department of Physical Therapy, University of Delaware, Newark, DE, USA; Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA.
Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA.
Arch Phys Med Rehabil. 2025 Sep 5. doi: 10.1016/j.apmr.2025.08.016.
To examine if exercise intensity, quantified as heart rate or training speed, predicts walking outcomes in people with chronic stroke.
This is a secondary analysis from a larger randomized clinical trial ("PROWALKS"; NIH1R01HD086362).
Four, outpatient rehabilitation clinics.
Participants with chronic stroke with a walking speed of 0.3-1.0m/s and step-activity of <8000 steps-per-day. This analysis included participants (n = 169; age: 63.1 ± 12.5, 46% female) with complete pre- and post-intervention data.
Participants were randomized into (1) fast-walking training or (2) fast-walking training and step-activity monitoring group. Of importance, participants received up to 36-sessions of 30-minute high-intensity treadmill walking training across 12-weeks.
MAIN OUTCOME MEASURE(S): The primary outcomes were a pre-to-post intervention change in six-minute walk test distance and fastest walking speed. Exercise intensity was quantified as either a percentage of heart rate reserve or self-selected walking speed.
Two separate multiple linear regressions with robust errors analyzed the relationship of exercise intensity metrics (% heart rate, training speed) on pre-to-post intervention changes in two walking capacity outcomes (Six-Minute Walk Test, Fastest Walking Speed) after accounting for covariates. Training speed was a significant predictor of both a change in Six-Minute Walk Test distance (b = 0.359 (95% CI [0.108 - 0.610]), p = 0.005) and Fastest Walking Speed (b = 0.001 (95% CI [0.001-0.002]), p = 0.003). Heart rate was not a significant predictor of either outcome (both p > 0.373).
Training speed significantly predicts changes in walking capacity outcomes in people with chronic stroke following a fast-walking treadmill intervention. This suggests rehabilitation clinicians may use training speed as the metric of exercise intensity when prescribing walking interventions to people with chronic stroke.
探讨以心率或训练速度量化的运动强度是否能预测慢性卒中患者的步行结果。
这是一项来自更大规模随机临床试验（“PROWALKS”；NIH1R01HD086362）的二次分析。
四家门诊康复诊所。
慢性卒中患者，步行速度为0.3 - 1.0米/秒，每日步数活动<8000步。该分析纳入了干预前后数据完整的参与者（n = 169；年龄：63.1±12.5，46%为女性）。
参与者被随机分为（1）快走训练组或（2）快走训练及步数活动监测组。重要的是，参与者在12周内接受了多达36节、每节30分钟的高强度跑步机快走训练。
主要结局是干预前后六分钟步行试验距离和最快步行速度的变化。运动强度以心率储备百分比或自我选择的步行速度进行量化。
在考虑协变量后，两个独立的稳健误差多元线性回归分析了运动强度指标（心率百分比、训练速度）与两个步行能力结局（六分钟步行试验、最快步行速度）干预前后变化之间的关系。训练速度是六分钟步行试验距离变化（b = 0.359（95%CI[0.108 - 0.610]），p = 0.005）和最快步行速度（b = 0.001（95%CI[0.001 - 0.002]），p = 0.003）的显著预测因素。心率不是任何一个结局的显著预测因素（p均>0.373）。
在快走跑步机干预后，训练速度能显著预测慢性卒中患者步行能力结局的变化。这表明康复临床医生在为慢性卒中患者开步行干预处方时，可将训练速度作为运动强度指标。
