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Prise en charge precoce des patients hemiplegiques en activites physiques adaptees: etude preliminaire (Early post-stroke physical conditioning in hemiplegic patients: a preliminary study) [French] |
Letombe A, Cornille C, Delahaye H, Khaled A, Morice O, Tomaszewski A, Olivier N |
Annals of Physical and Rehabilitation Medicine 2010 Dec;53(10):632-642 |
clinical trial |
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: To establish the value of an early post-stroke evaluation of cardiorespiratory fitness in hemiparetic patients using a one-leg cycling exercise test and to analyze the impact of an adapted physical activity programme 12 weeks after the stroke. PROTOCOL: Eighteen hemiparetic stroke patients participated in the study. The subjects were randomly assigned to one of two groups: the control group (CG) underwent 4 weeks of conventional rehabilitation, whereas the training group (TG) performed additional physical exercises. The initial evaluation (T1) was carried out after 1 week of exercise and the final evaluation (T2) was performed after 28 days. Both evaluations consisted of maximal graded tests performed with the valid leg, followed by completion of a questionnaire on personal autonomy in activities of daily living (ADL). RESULTS: In the CG group, we recorded a 4 to 8% increase in peak oxygen uptake (VO2peak). There was no significant increase in peak power output (Wpeak). However, the TG displayed significantly (p < 0.05) greater peak values than those recorded on study entry (Wpeak +30%, VO2peak +20%). The TG showed a statistically significant improvement in the Barthel and Katz ADL scale scores, whereas the pre- and post-rehabilitation values did not differ significantly in the CG. However, there was no correlation between the Barthel/Katz scale scores and Wpeak. CONCLUSION: Evaluation of cardiorespiratory fitness by using the valid leg seems to be feasible in hemiplegic patients 1. month post-stroke. Early post-stroke physical training appears to be needed to limit the negative effects of functional hypoactivity.
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