ABSTRACT
Objective:To observe the recovery of exercise tolerance among stroke survivors using the cardiopulmonary exercise test (CPET) and analyze the factors influencing it.Methods:A total of 81 stroke survivors hospitalized in the Department of Rehabilitation Medicine of our hospital in year 2018 and 2019 were selected. The general clinical data of all patients were collected retrospectively and combined with the data from CPET to establish a data set. Version 25.0 of the SPSS software was used for multiple linear regressions analysis, with the peak oxygen uptake as the dependent variable, and the age, Brunnstrom stage, peak power, peak heart rate, peak respiratory exchange ratio, peak breathing reserve, peak ventilation per minute, the slope of the VE-VCO 2 curve (ΔVE/ΔVCO 2) and peak end tidal partial pressure of carbon dioxide as independent variables. Results:Stroke survivors at Brunnstrom stage III Ⅲ, Ⅳ and Ⅴ or higher decreased sequentially with their age, but their peak oxygen uptake increased gradually. The multiple linear regression model constructed by " stepwise method" showed that the fitted multiple linear regression equation was statistically significant ( F=100.228, P<0.001). Moreover, the average peak power, peak heart rate, peak ventilation per minute and the slope of the VE-VCO 2 curve were all found to be significant independent predictors of peak oxygen uptake in these stroke survivors. Conclusions:Skeletal muscle power, cardiac function, pulmonary ventilation and ventilation efficiency are useful independent predictors of the exercise tolerance of stroke survivors.
ABSTRACT
Objective To observe the effect of body weight supported treadmill training ( BWSTT) on func-tion of lower extremities in stroke survivors, and analyze the influence of quadriceps femoris muscle tone on the thera-peutic effect of BWSTT. Methods Thirty-six stroke survivors were randomly divided into a BWSTT group and a conventional therapy group ( CT group) according to a random number table, each of 18. Both groups were given rou-tine rehabilitation training, while the BWSTT group was additionally provided with BWSTT for 4 weeks. Before and af-ter the treatment, Fugl-Meyer assessment for lower extremity (FMMS-LE), Berg balance scale (BBS) and Holden walking function rating scale ( Holden) were used to assess the motor function of lower extremities, balance function and walking ability of both groups. Meanwhile, the patients in BWSTT group were further divided into a mild-spasm subgroup and a seriously-spasm subgroup according to the modified Ashworth scale assessment result of quadriceps muscle, and the results of their efficacy indexes were further compared. Results No significant difference was found in the average FMMS-LE, Berg and Holden scores between the BWSTT group and CT group before the treat-ment ( P>0.05) . However, significantly improvement was found in all the above measurements of both groups after the treatment ( P<0.05) . Further comparison found that the FMMS score of the lower extremities and Holden grading in the BWSTT group improved more significantly compared with the CT group ( P<0.05) , while no significant differ-ences were found in the Berg score between the two groups ( P>0.05) . The change of FMMS (△FMMS) and Holden (△Holden) after treatment in the mild-spasm subgroup increased more significantly compared with those in the seri-ously-spasm subgroup, but no significant differences were observed regarding the change of Berg (△Berg) between the two subgroups. Conclusions BWSTT can significantly improve the motor function of lower extremities, balance function and walking ability of stroke survivors. However, hypertone of quadriceps femoris might have adverse effects on the therapeutic effect of BWSTT.