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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Outcomes in people after stroke attending an adapted cardiac rehabilitation exercise program: Does time from stroke make a difference?
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Outcomes in people after stroke attending an adapted cardiac rehabilitation exercise program: Does time from stroke make a difference?

机译：中风后参加一项适应性心脏康复锻炼计划的人的结果：中风后的时间会有所不同吗？

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Background Individuals referred to cardiac rehabilitation programs (CRPs) after stroke have demonstrated postprogram improvements in cardiovascular fitness (VO2peak). However, the effect of CRPs on other physiological/quality-of-life outcomes and effect of time from stroke on these results has not been investigated. The objectives of the present study are (1) to evaluate the effects of a CRP in participants with motor impairment after stroke and (2) to explore the effects of elapsed time from stroke on physiological/quality-of-life outcomes. Methods The CRP included 24 weeks of resistance and aerobic training. Primary outcomes in 120 participants, 25.4 ± 42.3 (mean ± standard deviation) months after stroke, included 6-minute walk distance (6MWD), VO2peak, timed repeated sit-to-stand performance, and affected-side isometric knee extensor strength (IKES). Secondary measures included gait characteristics (cadence, step lengths, and symmetry), walking speed, balance (Berg Balance Scale), affected-side range of motion (ROM), elbow flexor and grip strength, anaerobic threshold, and perceptions of participation/social reintegration. Results After adjusting for multiple comparisons, participants demonstrated significant improvements (all P .001) in 6MWD (283.2 ± 126.6 to 320.7 ± 141.8 m), sit-to-stand performance (16.3 ± 9.5 to 13.3 ± 7.1 seconds), affected-side IKES (25.9 ± 10.1 to 30.2 ± 11 kg as a percentage of body mass), and VO2peak (15.2 ± 4.5 to 17.2 ± 4.9 mL·kg·min-1). Participants also demonstrated post-CRP improvements in secondary outcomes: anaerobic threshold, balance, affected-side hip/shoulder ROM, grip and isometric elbow flexor strength, participation, walking speed, cadence (all P .001), and bilateral step lengths (P .04). In a linear regression model, there was a negative association between the change in 6MWD and time from stroke (β = -42.1; P =.002) independent of baseline factors. Conclusions A CRP yields improvements over multiple domains of recovery; however, those who start earlier demonstrate greater improvement in functional ambulation independent of baseline factors. These data support the use of adapted CRPs as a standard of care practice after conventional stroke rehabilitation.
机译：背景卒中后转入心脏康复计划（CRP）的个人已证明程序后心血管适应性（VO2peak）有所改善。但是，尚未研究CRP对其他​​生理/生活质量结局的影响以及中风后的时间对这些结果的影响。本研究的目的是（1）评估CRP对中风后运动障碍参与者的影响，以及（2）探索中风后经过的时间对生理/生活质量结局的影响。方法CRP包括24周的抵抗力和有氧训练。在卒中后25.4±42.3（平均±标准差）个月的120名参与者中，主要结局包括6分钟的步行距离（6MWD），VO2peak，定时重复的坐姿到站立表现以及患侧等距膝盖伸肌力量（IKES） ）。次要措施包括步态特征（节奏，步长和对称性），步行速度，平衡（Berg平衡量表），患侧运动范围（ROM），肘屈肌和握力，无氧阈值以及对参与/社交的感知重新融合。结果在调整了多个比较之后，参与者表现出6MWD（283.2±126.6至320.7±141.8 m），从站到站的表现（16.3±9.5至13.3±7.1秒）的显着改善（全部P <.001），侧面IKES（占体重的25.9±10.1至30.2±11千克）和VO2peak（15.2±4.5至17.2±4.9 mL·kg·min-1）。参与者还证明了CRP后的次级结局改善：无氧阈值，平衡，患侧髋部/肩部ROM，握力和等距肘屈肌力量，参与度，步行速度，节奏（所有P <.001）和双侧步长（ P <.04）。在线性回归模型中，与基线因素无关，6MWD的变化与卒中时间之间存在负相关关系（β= -42.1; P = .002）。结论CRP可以在多个恢复范围内产生改进;然而，那些较早开始的人表现出与基线因素无关的功能性移动方面的更大改善。这些数据支持在常规卒中康复后将适应的CRP用作护理实践的标准。

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