Lessons Learned: The Difficulties of Incorporating Intensity Principles Into Inpatient Stroke Rehabilitation
| Autor: | Eric D. Monsch, Addie Middleton, Chris Daughtry, Mark G. Bowden, Troy Powell, Sara Kraft |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Strength training medicine.medical_treatment Timed Up and Go test Walking Gait training Intervention (counseling) medicine Stroke Exercise Original Research lcsh:R5-920 Rehabilitation business.industry Tinetti test 5xSTS 5 times sit to stand 10-mw 10-meter walk test General Medicine medicine.disease Gait Physical therapy 2MWT 2-minute walk test business CFIR Consolidated Framework for Implementation Research lcsh:Medicine (General) SSWS self-selected walking speed |
| Zdroj: | Archives of Rehabilitation Research and Clinical Translation, Vol 2, Iss 2, Pp 100052-(2020) Archives of Rehabilitation Research and Clinical Translation |
| ISSN: | 2590-1095 |
| Popis: | Objective The objective of this study was to determine the feasibility of a rehabilitation approach focusing on cardiovascular, strength, and gait training intensity in the inpatient rehabilitation setting after a new onset of stroke. We additionally aimed to determine the efficacy of this intensity-based program on rehabilitation outcomes compared with usual care. Design Participants were pseudo-randomized to an intensity-based program focusing on gait, cardiovascular, and strength training or to usual care. Outcomes included FIM, 10-meter walk, 2-minute walk, timed Up and Go test, 5-time sit-to-stand test, and Tinetti balance assessment. Intervention The intervention consisted of 6 20-minute sessions per week dedicated to intensity of activity: 2 each for walking, cardiovascular training, and strength training. Participants Patients (N=49) with new onset stroke admitted to inpatient rehabilitation over the course of 1 year. Setting Four inpatient rehabilitation facilities with comprehensive neurologic rehabilitation teams. Results Thirty-five individuals (16 intervention, 19 controls) completed all testing. Subject compliance to the intensity intervention demonstrated completion of approximately half the prescribed sessions. All outcomes improved significantly from admission to discharge, and a significant interaction between treatment group and time was observed for the 2-minute walk and the Tinetti balance assessment. The 2-minute walk, Tinetti balance assessment, 10-meter walk, and FIM demonstrated between-group effect sizes greater than 0.60 in favor of the intervention group. Conclusions The intensity-based protocol was safe, and several measures demonstrated efficacy when compared with usual care. Results may have been limited by poor program compliance, showing a need to identify and ameliorate obstacles to integration of comprehensive intensity-based programs addressing endurance, strength, and gait training. Applying physiological principles of exercise to acute stroke rehabilitation demonstrates great promise for improving independent physical function. |
| Databáze: | OpenAIRE |
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