Silver, Kenneth H.C.
(University of Maryland, School of Medicine, Departmentof Neurology, Division of Rehabilitation Medicine, Department of Medicine, Division of Gerontology, Geriatric Research, Education and Clinical Center, BaltimoreVA Medical Center, Baltimore, MD 21201)
,
Macko, Richard F.
(University of Maryland, School of Medicine, Departmentof Neurology, Department of Medicine, Division of Gerontology, Geriatric Research, Education and Clinical Center, BaltimoreVA Medical Center, Baltimore, MD 21201)
,
Forrester, Larry W.
(Department of Physical Therapy)
,
Goldberg, Andrew P.
(Department of Medicine, Division of Gerontology, Geriatric Research, Education and Clinical Center, BaltimoreVA Medical Center, Baltimore, MD 21201)
,
Smith, Gerald V.
(Department of Physical Therapy)
It is widely assumed that only limited improvement in functional mobility is pos sible beyond the subacute period following ischemic stroke. Contrary to this notion, we studied "neurologically plateaued" stroke patients with chronic hemiparesis to as sess whether a "task-oriented" treadmill-training...
It is widely assumed that only limited improvement in functional mobility is pos sible beyond the subacute period following ischemic stroke. Contrary to this notion, we studied "neurologically plateaued" stroke patients with chronic hemiparesis to as sess whether a "task-oriented" treadmill-training regimen would improve walking speed, cadence, and gait cycle symmetry on a modified "Get-Up and Go" task. Five male patients with a mean age of 60.4 U00B1; 2.7 years (mean U00B1; S.D.) status post ischemic stroke (> 6 months prior) participated in this nonrandomized low-intensity tread mill exercise pilot study three times/week for 3 months. All patients had mild to mod erate gait asymmetries due to residual hemiparesis. Patients were videotaped before and after 3 months of treadmill aerobic exercise (AEX) while performing a functional task consisting of arising from a chair, walking 3.1 m without an assistive device as fast as safely possible, and returning to sit. Gait events were timed using a 2-D Peak MotusU2122; video analysis system. After 3 months AEX training, times for the overall "get-up and return-to-sit" (GURS) task and the "straight-away walk" (SAW) segment decreased from 8.2 U00B1; 1.4 sec to 6.5 U00B1; 0.8 sec (mean U00B1; SEM) (p U003C; 0.05), and from 3.7 U00B1; 1 sec to 2.8 U00B1; 0.7 sec (p U003C; 0.05), respectively. These data represent improve ments of 21% and 24% for the GURS and 'SAW segments, respectively. Mean veloc ity increased from 0.9 U00B1; 0.2 to 1.2 U00B1; 0.21 m/sec, a 33% improvement (p U003C; 0.01). Mean cadence (steps/min) increased from 89 U00B1; 9 to 97 U00B1; 8, a 9% increase (p U003C; 0.05). Mean stance and swing duration diminished for both paretic (P) and nonparetic (NP) limbs, and the intralimb stance/swing ratio values moved toward normal for both the paretic and nonparetic limbs. However, these latter changes reached significance only for the P limb. Interlimb stance symmetry was unchanged. The more impaired subjects experienced the greatest gains in gait velocity and temporal measures. Collectively, these findings indicate that treadmill exercise improves functional overground mo bility in individuals with chronic, stable hemiparesis. Key Words: Cerebrovascular diseaseU2014;HemiplegiaU2014;ExerciseU2014;Gait.
It is widely assumed that only limited improvement in functional mobility is pos sible beyond the subacute period following ischemic stroke. Contrary to this notion, we studied "neurologically plateaued" stroke patients with chronic hemiparesis to as sess whether a "task-oriented" treadmill-training regimen would improve walking speed, cadence, and gait cycle symmetry on a modified "Get-Up and Go" task. Five male patients with a mean age of 60.4 U00B1; 2.7 years (mean U00B1; S.D.) status post ischemic stroke (> 6 months prior) participated in this nonrandomized low-intensity tread mill exercise pilot study three times/week for 3 months. All patients had mild to mod erate gait asymmetries due to residual hemiparesis. Patients were videotaped before and after 3 months of treadmill aerobic exercise (AEX) while performing a functional task consisting of arising from a chair, walking 3.1 m without an assistive device as fast as safely possible, and returning to sit. Gait events were timed using a 2-D Peak MotusU2122; video analysis system. After 3 months AEX training, times for the overall "get-up and return-to-sit" (GURS) task and the "straight-away walk" (SAW) segment decreased from 8.2 U00B1; 1.4 sec to 6.5 U00B1; 0.8 sec (mean U00B1; SEM) (p U003C; 0.05), and from 3.7 U00B1; 1 sec to 2.8 U00B1; 0.7 sec (p U003C; 0.05), respectively. These data represent improve ments of 21% and 24% for the GURS and 'SAW segments, respectively. Mean veloc ity increased from 0.9 U00B1; 0.2 to 1.2 U00B1; 0.21 m/sec, a 33% improvement (p U003C; 0.01). Mean cadence (steps/min) increased from 89 U00B1; 9 to 97 U00B1; 8, a 9% increase (p U003C; 0.05). Mean stance and swing duration diminished for both paretic (P) and nonparetic (NP) limbs, and the intralimb stance/swing ratio values moved toward normal for both the paretic and nonparetic limbs. However, these latter changes reached significance only for the P limb. Interlimb stance symmetry was unchanged. The more impaired subjects experienced the greatest gains in gait velocity and temporal measures. Collectively, these findings indicate that treadmill exercise improves functional overground mo bility in individuals with chronic, stable hemiparesis. Key Words: Cerebrovascular diseaseU2014;HemiplegiaU2014;ExerciseU2014;Gait.
참고문헌 (31)
Broderick, Joseph, Brott, Thomas, Kothari, Rashmi, Miller, Rosie, Khoury, Jane, Pancioli, Arthur, Gebel, James, Mills, Debbie, Minneci, Laura, Shukla, Rakesh.
The Greater Cincinnati/Northern Kentucky Stroke Study : Preliminary First-Ever and Total Incidence Rates of Stroke Among Blacks.
Stroke,
vol.29,
no.2,
415-421.
Gresham, Glen E., Fitzpatrick, Therese E., Wolf, Philip A., McNamara, Patricia M., Kannel, William B., Dawber, Thomas R..
Residual Disability in Survivors of Stroke - The Framingham Study.
The New England journal of medicine,
vol.293,
no.19,
954-956.
Wade, D T, Hewer, R L.
Functional abilities after stroke: measurement, natural history and prognosis..
Journal of neurology, neurosurgery, and psychiatry,
vol.50,
no.2,
177-182.
Powell, Kenneth E, Caspersen, Carl J, Koplan, Jeffrey P, Ford, Earl S.
Physical activity and chronic diseases.
The American journal of clinical nutrition,
vol.49,
no.5,
999-1006.
Jørgensen, Henrik S., Nakayama, Hirofumi, Raaschou, Hans O., Olsen, Tom S..
Recovery of walking function in stroke patients: The copenhagen stroke study.
Archives of physical medicine and rehabilitation,
vol.76,
no.1,
27-32.
Duncan, P W, Goldstein, L B, Matchar, D, Divine, G W, Feussner, J.
Measurement of motor recovery after stroke. Outcome assessment and sample size requirements..
Stroke,
vol.23,
no.8,
1084-1089.
Rodriquez, Arthur A., Black, Pamela O., Kile, Kay A., Sherman, Jack, Stellberg, Beth, McCormick, James, Roszkowski, Jane, Swiggum, Eileen.
Gait training efficacy using a home-based practice model in chronic hemiplegia.
Archives of physical medicine and rehabilitation,
vol.77,
no.8,
801-805.
Dam, M, Tonin, P, Casson, S, Ermani, M, Pizzolato, G, Iaia, V, Battistin, L.
The effects of long-term rehabilitation therapy on poststroke hemiplegic patients..
Stroke,
vol.24,
no.8,
1186-1191.
Werner, Robert A., Kessler, Susan.
EFFECTIVENESS OF AN INTENSIVE OUTPATIENT REHABILITATION PROGRAM FOR POSTACUTE STROKE PATIENTS1 :.
American journal of physical medicine & rehabilitation,
vol.75,
no.2,
114-120.
Richards, Carol L., Malouin, Francine, Wood-Dauphinee, Sharon, Williams, J.I., Bouchard, Jean-Pierre, Brunet, Denis.
Task-specific physical therapy for optimization of gait recovery in acute stroke patients.
Archives of physical medicine and rehabilitation,
vol.74,
no.6,
612-620.
Hesse, Stefan, Bertelt, Christine, Schaffrin, Antje, Malezic, Matija, Mauritz, Karl-Heinz.
Restoration of gait in nonambulatory hemiparetic patients by treadmill training with partial body-weight support.
Archives of physical medicine and rehabilitation,
vol.75,
no.10,
1087-1093.
Visintin, M, Barbeau, H.
The effects of parallel bars, body weight support and speed on the modulation of the locomotor pattern of spastic paretic gait. A preliminary communication.
Paraplegia,
vol.32,
no.8,
540-553.
Hesse, S A, Jahnke, M T, Bertelt, C M, Schreiner, C, Lücke, D, Mauritz, K H.
Gait outcome in ambulatory hemiparetic patients after a 4-week comprehensive rehabilitation program and prognostic factors..
Stroke,
vol.25,
no.10,
1999-2004.
Macko, R. F., Katzel, L. I., Yataco, A., Tretter, L. D., DeSouza, C. A., Dengel, D. R., Smith, G. V., Silver, K. H..
Low-Velocity Graded Treadmill Stress Testing in Hemiparetic Stroke Patients.
Stroke,
vol.28,
no.5,
988-992.
Proceedings of the American Society for Neurorehabilitation 4th Annual Conference Silver KH
Ann Neurol Smith GV 63 122 1997
McCOMAS, ALAN J..
Human neuromuscular adaptations that accompany changes in activity :.
Medicine and science in sports and exercise,
vol.26,
no.12,
1498???1509-.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.