不同运动模式对脑卒中患者步行及平衡功能的效果比较

doi:10.3969/j.issn.1006-9771.2025.08.005

Abstract

Abstract:

Objective To compare the effect of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) on gait and balance for stroke patients.

Methods From December, 2023 to December, 2024, 96 patients with post-stroke gait and balance dysfunction were selected from the First Affiliated Hospital of Bengbu Medical University, and randomly divided into control group (n= 32), MICT group (n= 32) and HIIT group (n= 32). The control group received routine comprehensive rehabilitation therapy, while MICT and HIIT groups received additional respective training, for four weeks. They were measured with symmetry indexes (SI) of mean pressure and footprint area during eyes-open and eyes-closed condition, as well as anterior-posterior and medial-lateral displacement of the center of mass, before and after treatment; while they were assessed with Berg Balance Scale (BBS), distance of 6-minute walk test (6MWT), time of Timed Up & Go test (TUGT) and 10-meter walk test (10MWT), and Fugl-Meyer Assessment-Lower Extremities (FMA-LE).

Results The main effects of time (F> 351.683, P< 0.001) and groups (F> 4.945, P< 0.05), and the interaction effects (F> 16.919, P< 0.001) were significant for BBS scores, distance of 6MWT, time of TUGT and 10MWT, and FMA-LE scores; and all the indicators were better in MICT group and HIIT group than in the control group (P < 0.05) after treatment, and they were better in HIIT group than in MICT group (P < 0.05) except BBS score. Under eyes-open condition, the main effects of time (F > 64.684, P < 0.001) and groups (F > 9.472, P < 0.001), and the interaction effects (F > 10.562, P < 0.001) were significant for SI of mean pressure and footprint area, and anterior-posterior and medial-lateral displacement of the center of mass; and all the indicators were better in MICT group and HIIT group than in the control group (P < 0.001) after treatment, and they were better in HIIT group than in MICT group (P < 0.05). Under eyes-closed condition, the main effects of time (F > 107.730, P < 0.001) and groups (F > 4.275, P < 0.05), and the interaction effects (F > 7.985, P < 0.05) were significant for SI of mean pressure and footprint area, and anterior-posterior and medial-lateral displacement of the center of mass; and SI of mean pressure was better in HIIT group than in MICT group (P < 0.05), the other indicators were better in MICT group and HIIT group than in the control group (P < 0.001) after treatment.

Conclusion Both HIIT and MICT can improve gait and balance for stroke patients, and HIIT is more effective on gait and static balance with eyes open, but similar on static balance with eyes closed.

Key words: stroke, high-intensity interval training, moderate-intensity continuous training, gait ability, balance

CLC Number:

R743.3

ZHANG Ziang, CHEN Jing, SHEN Mengru, GENG Zongxiao, HAN Xue, ZHAO Xu, XU Lei. Comparison of effect of different types of exercise on gait and balance for stroke patients[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(8): 896-905.

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References 43

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组别	n	性别 (男/女)/n	年龄/岁	病程/d	病变性质 (缺血/出血)/n	偏瘫侧 (左/右)/n	病变部位 (a/b/c/d/e)/n
对照组	32	16/16	58.13±7.061	60.91±16.231	19/13	21/11	6/6/0/17/3
MICT组	32	24/8	56.34±8.288	69.56±19.844	18/14	14/18	7/4/1/16/4
HIIT组	32	20/12	55.09±7.562	57.47±13.318	20/12	21/11	6/5/0/17/4
χ²/F值		4.267	1.268	2.177	0.259	4.200
P值		0.118	0.286	0.115	0.878	0.122	0.987^*

项目	组别	n	治疗前		治疗后
项目	组别	n	均值	标准差	均值	标准差
BBS评分	对照组	32	42.63	3.998	46.25	3.885
	MICT组	32	43.16	5.181	50.16	2.689
	HIIT组	32	43.34	4.037	50.78	2.697
6MWT距离/m	对照组	32	215.39	76.579	239.90	75.781
	MICT组	32	210.24	86.215	282.07	84.557
	HIIT组	32	219.10	80.923	337.26	86.416
TUGT时间/s	对照组	32	21.17	7.183	16.68	6.459
	MICT组	32	19.26	5.604	13.74	3.212
	HIIT组	32	20.57	4.919	11.46	2.170
10MWT时间/s	对照组	32	14.76	2.842	12.49	2.872
	MICT组	32	14.61	2.530	11.01	2.871
	HIIT组	32	15.14	2.815	9.51	2.897
FMA-LE评分	对照组	32	17.31	3.922	21.37	3.160
	MICT组	32	17.81	3.487	23.84	2.604
	HIIT组	32	18.03	3.623	27.94	2.510

变量		平方和	自由度	均方	F值	P值
BBS评分	组间	255.542	2	127.771	4.945	0.009
	组内	1740.021	1	1740.021	456.424	< 0.001
	组内×组间	139.292	2	69.646	18.629	< 0.001
6MWT距离	组间	83670.442	2	41835.221	42.144	< 0.001
	组内	245388.000	1	245388.000	1002.804	< 0.001
	组内×组间	70160.482	2	35080.241	143.395	< 0.001
TUGT时间	组间	311.131	2	155.565	9.427	< 0.001
	组内	1947.819	1	1947.819	351.683	< 0.001
	组内×组间	187.412	2	93.706	16.919	< 0.001
10MWT时间	组间	55.518	2	27.759	17.428	< 0.001
	组内	705.333	1	705.333	633.218	< 0.001
	组内×组间	91.838	2	45.919	43.177	< 0.001
FMA-LE评分	组间	428.948	2	214.474	11.716	< 0.001
	组内	2133.333	1	2133.333	729.999	< 0.001
	组内×组间	282.885	2	141.443	48.400	< 0.001

变量	组别	组别	平均值差	P值	95%CI
变量	组别	组别	平均值差	P值	上限	下限
BBS评分	对照组	MICT组	-2.220	0.015	-4.000	-0.440
	对照组	HIIT组	-2.620	0.004	-4.410	-0.830
	MICT组	HIIT组	-0.410	0.652	-2.190	1.370
6MWT距离	对照组	MICT组	-47.514	0.001	-77.863	-17.165
	对照组	HIIT组	-81.261	< 0.001	-111.611	-50.911
	MICT组	HIIT组	-49.022	0.014	-79.372	-18.672
TUGT时间	对照组	MICT组	2.423	0.005	1.016	3.830
	对照组	HIIT组	4.405	< 0.001	2.935	5.875
	MICT组	HIIT组	1.839	0.041	0.369	3.309
10MWT时间	对照组	MICT组	1.212	0.019	0.377	2.047
	对照组	HIIT组	2.521	< 0.001	1.686	3.356
	MICT组	HIIT组	1.142	0.037	0.342	1.942
FMA-LE评分	对照组	MICT组	-1.740	0.017	-2.990	-0.020
	对照组	HIIT组	-3.640	< 0.001	-5.140	-2.140
	MICT组	HIIT组	-2.160	0.005	-3.660	-0.650

项目	组别	n	治疗前		治疗后
项目	组别	n	均值	标准差	均值	标准差
平均压力SI	对照组	32	0.66	0.100	0.61	0.071
	MICT组	32	0.66	0.095	0.56	0.045
	HIIT组	32	0.65	0.082	0.53	0.039
足印面积SI	对照组	32	0.57	0.045	0.56	0.042
	MICT组	32	0.56	0.077	0.53	0.041
	HIIT组	32	0.56	0.076	0.50	0.039
身体质心前后向位移/cm	对照组	32	1.49	0.262	1.24	0.243
	MICT组	32	1.36	0.317	1.08	0.183
	HIIT组	32	1.38	0.208	0.90	0.214
身体质心内外向位移/cm	对照组	32	2.03	0.329	1.69	0.285
	MICT组	32	2.20	0.300	1.37	0.283
	HIIT组	32	2.09	0.282	1.08	0.227

Comparison of effect of different types of exercise on gait and balance for stroke patients

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变量		平方和	自由度	均方	F值	P值
平均压力SI	组间	0.062	2	0.031	9.746	< 0.001
	组内	0.389	1	0.389	241.141	< 0.001
	组内×组间	0.031	2	0.015	14.475	< 0.001
足印面积SI	组间	0.028	2	0.014	9.472	< 0.001
	组内	0.052	1	0.052	64.684	< 0.001
	组内×组间	0.015	2	0.008	10.562	< 0.001
身体质心前后向位移	组间	1.650	2	0.825	10.709	< 0.001
	组内	5.373	1	5.373	541.436	< 0.001
	组内×组间	0.490	2	0.245	24.698	< 0.001
身体质心内外向位移	组间	2.564	2	1.282	14.155	< 0.001
	组内	25.528	1	25.528	3916.037	< 0.001
	组内×组间	3.815	2	1.907	292.610	< 0.001

变量		平方和	自由度	均方	F值	P值
平均压力SI	组间	0.075	2	0.038	17.527	< 0.001
	组内	0.202	1	0.202	205.698	< 0.001
	组内×组间	0.065	2	0.033	33.378	< 0.001
足印面积SI	组间	0.022	2	0.011	4.275	0.024
	组内	0.045	1	0.045	107.730	< 0.001
	组内×组间	0.007	2	0.003	7.985	0.001
身体质心前后向位移距离	组间	0.257	2	0.128	10.481	< 0.001
	组内	2.293	1	2.293	550.320	< 0.001
	组内×组间	0.618	2	0.309	74.186	< 0.001
身体质心内外向位移距离	组间	0.374	2	0.187	53.512	< 0.001
	组内	7.211	1	7.211	1823.702	< 0.001
	组内×组间	1.101	2	0.550	139.208	< 0.001

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项目	组别	n	治疗前		治疗后
项目	组别	n	均值	标准差	均值	标准差
平均压力SI	对照组	32	0.69	0.088	0.66	0.079
	MICT组	32	0.67	0.093	0.61	0.062
	HIIT组	32	0.69	0.097	0.57	0.048
足印面积SI	对照组	32	0.58	0.060	0.56	0.045
	MICT组	32	0.57	0.068	0.54	0.047
	HIIT组	32	0.57	0.066	0.53	0.033
身体质心前后向位移距离/cm	对照组	32	1.75	0.354	1.68	0.346
	MICT组	32	1.75	0.386	1.51	0.317
	HIIT组	32	1.83	0.382	1.48	0.284
身体质心内外向位移距离/cm	对照组	32	2.39	0.448	2.22	0.382
	MICT组	32	2.55	0.416	2.06	0.397
	HIIT组	32	2.46	0.454	1.96	0.419