Macko R F, DeSouza C A, Tretter L D, Silver K H, Smith G V, Anderson P A, Tomoyasu N, Gorman P, Dengel D R
Neurology Service, Department of Veterans Affairs Medical Center, Baltimore, MD, USA.
Stroke. 1997 Feb;28(2):326-30. doi: 10.1161/01.str.28.2.326.
Elevated energy costs of hemiparetic gait contribute to functional disability after stroke, particularly in physically deconditioned older patients. We investigated the effects of 6 months of treadmill aerobic exercise training on the energy expenditure and cardiovascular demands of submaximal effort ambulation in stroke patients with chronic hemiparetic gait.
Nine older stroke patients with chronic hemiparetic gait were enrolled in a 6-month program of low-intensity aerobic exercise using a graded treadmill. Repeated measures of energy expenditure based on steady state oxygen consumption during a standardized 1-mph submaximal effort treadmill walking task were performed before and after training.
Six months of exercise training produced significant reductions in energy expenditure (n = 9; 3.40 +/- 0.27 versus 2.72 +/- 0.25 kcal/min [mean +/- SEM]; P < .005) during a given submaximal effort treadmill walking task. Repeated measures analysis in the subset of patients (n = 8) tested at baseline and after 3 and 6 months revealed that reductions in energy expenditure were progressive (F = 11.1; P < .02) and that exercise-mediated declines in both oxygen consumption (F = 9.7; P < .02) and respiratory exchange ratio (F = 13.4; P < .01) occurred in a strong linear pattern. These stroke patients could perform the same standardized submaximal exercise task at progressively lower heart rates after 3 months (96 +/- 4 versus 87 +/- 4 beats per minute) and 6 months of training (82 +/- 4 beats per minute; F = 35.4; P < .002).
Six months of low-intensity treadmill endurance training produces substantial and progressive reductions in the energy expenditure and cardiovascular demands of walking in older patients with chronic hemiparetic stroke. This suggests that task-oriented aerobic exercise may improve functional mobility and the cardiovascular fitness profile in this population.
偏瘫步态的能量消耗增加会导致中风后功能障碍，尤其是在身体机能下降的老年患者中。我们研究了6个月的跑步机有氧运动训练对慢性偏瘫步态中风患者次最大努力行走时的能量消耗和心血管需求的影响。
9名患有慢性偏瘫步态的老年中风患者参加了一项为期6个月的低强度有氧运动计划，使用分级跑步机。在训练前后，基于标准化的1英里/小时次最大努力跑步机行走任务期间的稳态耗氧量，对能量消耗进行重复测量。
6个月的运动训练使在给定的次最大努力跑步机行走任务期间的能量消耗显著降低（n = 9；3.40±0.27对2.72±0.25千卡/分钟[平均值±标准误]；P <.005）。对在基线以及3个月和6个月后进行测试的患者子集（n = 8）进行的重复测量分析显示，能量消耗的降低是渐进性的（F = 11.1；P <.02），并且运动介导的耗氧量（F = 9.7；P <.02）和呼吸交换率（F = 13.4；P <.01）的下降呈强烈的线性模式。这些中风患者在3个月（96±4对87±4次/分钟）和6个月训练后（82±4次/分钟；F = 35.4；P <.002）能够以逐渐降低的心率进行相同的标准化次最大运动任务。
6个月的低强度跑步机耐力训练可使慢性偏瘫性中风老年患者行走时的能量消耗和心血管需求大幅且渐进性降低。这表明以任务为导向的有氧运动可能会改善该人群的功能移动性和心血管健康状况。
