Hesse S, Bertelt C, Jahnke M T, Schaffrin A, Baake P, Malezic M, Mauritz K H
Department of Neurological Rehabilitation, Free University Berlin, Germany.
Stroke. 1995 Jun;26(6):976-81. doi: 10.1161/01.str.26.6.976.
Treadmill training with partial body weight support is a new and promising therapy in gait rehabilitation of stroke patients. The study intended to investigate its efficiency compared with gait training within regular physiotherapy in nonambulatory patients with chronic hemiparesis.
An A-B-A single-case study design compared treadmill training plus partial body weight support (A) with physiotherapy based on the Bobath concept (B) in seven nonambulatory hemiparetic patients. The minimum poststroke interval was 3 months, and each treatment phase lasted 3 weeks. Variables were gait ability assessed by the Functional Ambulation Category, other motor functions tested by the Rivermead Motor Assessment, muscle strength assessed by the Motricity Index, muscle tone rated by the Modified Ashworth Spasticity Scale, and gait cycle parameters.
Treadmill training was more effective with regard to restoration of gait ability (P < .05) and walking velocity (P < .05). Other motor functions improved steadily during the study. Muscle strength did not change, and muscle tone varied in an unsystematic way. The ratio of cadence to stride length did not alter significantly.
Treadmill training offers the advantages of task-oriented training with numerous repetitions of a supervised gait pattern. It proved powerful in gait restoration of nonambulatory patients with chronic hemiparesis. Treadmill training could therefore become an adjunctive tool to regain walking ability in a shorter period of time.
部分体重支持下的跑步机训练是中风患者步态康复中一种新的且有前景的治疗方法。本研究旨在调查其与慢性偏瘫非步行患者常规物理治疗中的步态训练相比的有效性。
采用A - B - A单病例研究设计,对7例非步行偏瘫患者比较了跑步机训练加部分体重支持(A)与基于Bobath概念的物理治疗(B)。中风后最短间隔为3个月,每个治疗阶段持续3周。变量包括通过功能性步行分类评估的步态能力、通过Rivermead运动评估测试的其他运动功能、通过运动指数评估的肌肉力量、通过改良Ashworth痉挛量表评定的肌张力以及步态周期参数。
在恢复步态能力(P <.05)和步行速度(P <.05)方面,跑步机训练更有效。在研究过程中其他运动功能稳步改善。肌肉力量未改变,肌张力变化无规律。步频与步幅的比率无显著改变。
跑步机训练具有任务导向训练的优势,可多次重复有监督的步态模式。它在慢性偏瘫非步行患者的步态恢复中被证明有效。因此,跑步机训练可成为在较短时间内恢复步行能力的辅助工具。