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Comparison of the Effects of Task-Oriented Circuit Training and Treadmill Training on Walking Function and Quality of Life in Patients With Post-Stroke Hemiparesis: Randomized Controlled Pilot Trial

뇌졸중 환자의 보행기능과 삶의 질에 대한 과제지향적 순환식 보행훈련과 트레드밀 보행 훈련의 효과 비교: 무작위 대조군 예비연구

  • Youn, Hye-jin (Dept. of Physical Therapy, The Graduate School, Daejeon University) ;
  • Oh, Duck-won (Dept. of Physical Therapy, College of Health Science, Cheongju University)
  • 윤혜진 (대전대학교 일반대학원 물리치료학과) ;
  • 오덕원 (청주대학교 보건의료대학 물리치료학과)
  • Received : 2016.01.25
  • Accepted : 2016.03.22
  • Published : 2016.05.21

Abstract

Background: Many studies regarding task-oriented training have recently demonstrated functional improvement in patients with post-stroke hemiparesis. The task-oriented approach is very diverse, and chronic stroke patients must have access to a sustained systematic treatment program to enhance their walking ability. Objectives: This study aimed to compare the effects of the task-oriented circuit training and treadmill training on walking function and quality of life in patients with chronic stroke. Methods: Fourteen patients with chronic stroke volunteered for this study. The subjects were randomly divided into a task-oriented circuit training group and a treadmill training group with 7 patients in each. Each training regimen was performed for 30 min a day and 3 days a week for 4 weeks. Assessment tools included the Timed Up-and-Go Test (TUGT), 10-m Walk Test, 6-min Walk Test (6MWT), and the Stroke Impact Scale (SIS). Results: The change in results of the TUGT, 6MWT, and SIS measured prior to and following the training regimens appeared to be significantly different between the two groups (p<.05). In addition, after the intervention, significant differences were found for all parameters in the task-oriented circuit training group and for the TUGT, 6MWT, and SIS in the treadmill training group (p<.05). Conclusion: The findings suggest that task-related circuit training and treadmill training may be helpful to improve walking function and quality of life of patients with post-stroke hemiparesis. Additionally, a task-related circuit training program may achieve more favorable outcomes than a treadmill program.

Keywords

References

  1. Calvert MJ, Freemantle N. Use of health-related quality of life in prescribing research. Part 1: Why evaluate health-related quality of life? J Clin Pharm Ther. 2003;28(6):513-521. https://doi.org/10.1046/j.0269-4727.2003.00521.x
  2. Carod-Artal FJ, Egido JA. Quality of life after stroke: The importance of a good recovery. Cerebrovasc Dis. 2009;27 Suppl 1:204-214.
  3. Carr JH., Shepherd RB. Stroke Rehabilitation: Guideline for exercise and training to optimize motor skill. 1st ed. London, Butterworth Heinemann, 2003:3-31.
  4. Chisari C, Venturi M, Bertolucci F, et al. Benefits of an intensive task-oriented circuit training in Multiple Sclerosis patients with mild disability. NeuroRehabilitation. 2014;35(3):509-518. http://dx.doi.org/10.3233/NRE-141144
  5. Cho GH, Lee SM, Woo YK. The effects of a task-related circuits program on functional improvements in stroke patients. Phys Ther Korea. 2004;11(3):59-70.
  6. Choi HH. Modified speed-dependent treadmill training plus body weight support enhances cardiorespiratory function in ambulatory chronic hemiparetic stroke patients. Korean Journal of Adapted Physical Activity. 2007;15(4):223-243. https://doi.org/10.17006/kjapa.2007.15.4.223
  7. Combs-Miller SA, Kalpathi Parameswaran A, Colburn D, et al. Body weight-supported treadmill training vs. overground walking training for persons with chronic stroke: A pilot randomized controlled trial. Clin Rehabil. 2014;28(9):873-884. http://dx.doi.org/10.1177/0269215514520773
  8. Danielsson A, Sunnerhagen KS. Oxygen consumption during treadmill walking and without body weight support in patients with hemiparesis after stroke and in healthy subjects. Arch Phys Med Rehabil. 2000;81(7):953-957. https://doi.org/10.1053/apmr.2000.6283
  9. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: A randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4):409-417. https://doi.org/10.1053/mr.2000.3839
  10. Duncan P, Studenski S, Richards L, et al. Randomized clinical trial of therapeutic exercise in subacute stroke. Stroke. 2003;34(9):2173-2180. https://doi.org/10.1161/01.STR.0000083699.95351.F2
  11. Duncan PW, Wallace D, Lai SM, et al. The stroke impact scale version 2.0. Evaluation of reliability, validity and sensitivity to change. Stroke. 1999; 30(10):2131-2140. https://doi.org/10.1161/01.STR.30.10.2131
  12. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5 Pt 1):1384-1387. https://doi.org/10.1164/ajrccm.158.5.9710086
  13. Fernandez-del-Olmo MA, Sanchez JA, Bello O, et al. Treadmill training improves overground walking economy in Parkinson's disease: A randomized, controlled pilot study. Front Neurol. 2014;5:191. http://dx.doi.org/10.3389/fneur.2014.00191
  14. Folstein MF, Folstem SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198. https://doi.org/10.1016/0022-3956(75)90026-6
  15. French B, Leathley M, Sutton C, et al. A systematic review of repetitive functional task practice with modeling of resource use, costs and effectiveness. Health Technol Assess. 2008;12(30):1-117.
  16. Hesse S, Werner C, Bardeleben A, et al. Body weight-supported treadmill training after stroke. Curr Atheroscler Rep. 2001;3(4):287-294. https://doi.org/10.1007/s11883-001-0021-z
  17. Hwang EO, Oh DW, Kim SY, et al. Effects of community-based adaptive ambulation training on walking function in patients with post-stroke hemiparesis. Korean J Health Promot. 2010;10(2):78-85.
  18. Ivey FM, Hafer-Macko CE, Macko RF. Task-oriented treadmill exercise training in chronic hemiparetic stroke. J Rehabil Res Dev. 2008;45(2):249-259. https://doi.org/10.1682/JRRD.2007.02.0035
  19. Ji SG, Cha HG. The effects of community ambulation training on the gait ability and stroke impact scale in stroke patients. Journal of the Korea Academia-Industrial Cooperation Society. 2013;14(6):2788-2794. https://doi.org/10.5762/KAIS.2013.14.6.2788
  20. Kim CY, Park IM, Oh DW. Comparison of the effect of treadmill gait training and overground gait training on gait function in stroke patients. Kor J Neural Rehabil. 2011;1(1):13-20.
  21. Kim HH, Hur JG, Yang YY. Effects of treadmill gait training on gait patterns in hemiplegic patients: Comparison with conventional gait training. The Korean Academy of Physical Therapy Science. 2003;10(2):17-28.
  22. Kim SM, Han EY, Kim BR, et al. Clinical application of circuit training for subacute stroke patients: A preliminary study. J Phys Ther Sci. 2016;28(1):169-174. http://dx.doi.org/10.1589/jpts.28.16javascript:checkRefBr('', 'next');9
  23. Krebs DE, Scarborough DM, McGibbon CA. Functional vs. strength training in disabled elderly outpatients. Am J Phys Med Rehabil. 2007;86(2):93-103. https://doi.org/10.1097/PHM.0b013e31802ede64
  24. Kwon OH, Woo Y, Lee JS, et al. Effects of task-oriented treadmill-walking training on walking ability of stroke patients. Top Stroke Rehabil. 2015; 22(6):444-452. http://dx.doi.org/10.1179/1074935715Z.00000000057
  25. Laufer Y, Dickstein R, Chefez Y, et al. The effect of treadmill training on the ambulation of stroke survivors in the early stages of rehabilitation: A randomized study. J Rehabil Res Dev. 2001;38(1): 69-78.
  26. Lee DJ, Cho YM, Lee WH. The effect of a task-related training on static balance and walking in chronic stroke patients. Journal of Korea Sport Research. 2007;18(6):61-70.
  27. Lee HY, Kim YL, Lee SM. Effects of virtual reality-based training and task-oriented training on balance performance in stroke patients. J Phys Ther Sci. 2015;27(6):1883-1888. http://dx.doi.org/10.1589/jpts.27.1883
  28. Lee JH, Shin HI, Jeong YS. Reliability of 6-minute walk test in stroke patients. J Korean Geriatr Soc. 2005;9(1):39-44.
  29. Lord SE, Rochester L, Weatherall M, et al. The effect of environment and task on gait parameters after stroke: A randomized comparison of measurement conditions. Arch Phys Med Rehabil. 2006;87(7):967-973. https://doi.org/10.1016/j.apmr.2006.03.003
  30. MaNevin NH, Wulf G, Carlson C. Effects of attentional focus, self-control, and dyad training on motor learning: Implications for physical rehabilitation. Phys Ther. 2000;80(4):373-385. https://doi.org/10.1093/ptj/80.4.373
  31. Mauritz KH. Gait training in hemiplegia. Eur J Neurol. 2002;9 Suppl 1:23-29.
  32. Miller EW, Quinn ME, Seddon PG. Body weight support treadmill and overground ambulation training for two patients with chronic disability secondary to stroke. Phys Ther. 2002;82(1):53-61. https://doi.org/10.1093/ptj/82.1.53
  33. Mossberg KA. Reliability of a timed walk test in persons with acquired brain injury. Am J Phys Med Rehabil. 2003;82(5):385-390. https://doi.org/10.1097/01.PHM.0000052589.96202.BE
  34. Nilsson L. Carlsson J, Danielsson A, et al. Walking training of patients with hemiparesis at and early stage after stroke: A comparison of walking train ing on a treadmill with body weight support and walking training on the ground. Clin Rehabil. 2001;15(5):515-527. https://doi.org/10.1191/026921501680425234
  35. Park HS. Effects of the group task-related program training on functional independence and quality of life for the CVA patients. Seoul, Dankook University, Master Thesis. 2005.
  36. Patterson SL, Forrester LW, Rodgers MM, et al. Determinants of walking function after stroke: Differences by deficit severity. Arch Phys Med Rehabil. 2007;88(1):115-119. https://doi.org/10.1016/j.apmr.2006.10.025
  37. Podsiadlo D, Richardson S. The timed "Up & Go": A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  38. Pohl M, Mehrholz J, Ritschel C, et al. Speed-dependent treadmill training in ambulatory hemiparetic stroke patients: A randomized controlled trial. Stroke. 2002;33(2):553-558. https://doi.org/10.1161/hs0202.102365
  39. Raju RS, Sarma PS, Pandian JD. Psychosocial problems, quality of life, and functional independence among Indian stroke survivors. Stroke. 2010;41(12):2932-2937. http://dx.doi.org/10.1161/STROKEAHA.110.596817
  40. Roerdink M, Lamoth CJ, Kwakkel G, et al. Gait coordination after stroke: Benefits of acoustically paced treadmill walking. Phys Ther. 2007;87(8): 1009-1022. https://doi.org/10.2522/ptj.20050394
  41. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68-78. https://doi.org/10.1037/0003-066X.55.1.68
  42. Salbach NM, Mayo NE, Wood-Dauphinee S, et al. A task-orientated intervention enhances walking distance and speed in the first year post stroke: A randomized controlled trial. Clin Rehabil. 2004;18(5):509-519. https://doi.org/10.1191/0269215504cr763oa
  43. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.
  44. Silsupadol P, Siu KC, Shumway-Cook A, et al. Training of balance under single and dual-task conditions in older adults with balance impairment. Phys Ther. 2006;86(2):269-281.
  45. Steffen TM, Hacker TA, Mollinger L. Age- and gen der-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test and gait speeds. Phys Ther. 2002;82(2):128-137. https://doi.org/10.1093/ptj/82.2.128
  46. Straudi S, Martinuzzi C, Pavarelli C, et al. A task-oriented circuit training in multiple sclerosis: A feasibility study. BMC Neurol. 2014;14:124. http://dx.doi.org/10.1186/1471-2377-14-124
  47. Sullivan KJ, Knowlton BJ, Dobkin BH. Step training with body weight support: Effect of treadmill speed and practice paradigms on poststroke locomotor recovery. Arch Phys Med Rehabil. 2002;83(5):683-691. https://doi.org/10.1053/apmr.2002.32488
  48. Sunnerhagen KS. Circuit training in community-living "younger" men after stroke. J Stroke cerebrovasc Dis. 2007;16(3):122-129. https://doi.org/10.1016/j.jstrokecerebrovasdis.2006.12.003
  49. Timmermans AA, Lemmens RJ, Monfrance M, et al. Effects of task-oriented robot training on arm function, activity, and quality of life in chronic stroke patients: A randomized controlled trial. J Neuroeng Rehabil. 2014;11:45. http://dx.doi.org/10.1186/1743-0003-11-45
  50. Veerbeek JM van Wegen E, van Peppen R, et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS One. 2014;9(2):e87987. http://dx.doi.org/10.1371/journal.pone.0087987
  51. Wu C, Trombly CA, Lin K, et al. A kinematic study of contextual effects on reaching performance in persons with and without stroke: Influences of object availability. Arch Phys Med Rehabil. 2000; 81(1):95-101. https://doi.org/10.1016/S0003-9993(00)90228-4
  52. Yang YR, Tsai MP, Chuang TY, et al. Virtual reality-based training improves community ambulation in individuals with stroke: A randomized controlled trial. Gait Posture. 2008;28(2):201-206. http://dx.doi .org/10.1016/j.gaitpost.2007.11.007
  53. Yang YR, Wang RY, Chen YC, et al. Dual-task exercise improves walking ability in chronic stroke: A randomized controlled trial. Arch Phys Med Rehabil. 2007;88(10):1236-1240. https://doi.org/10.1016/j.apmr.2007.06.762

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