RESUMO
High-intensity interval training (HIIT) has been shown to benefit stroke patients when implemented three months post-stroke. This study examined HIIT's feasibility and clinical effectiveness in the early post-stroke stage in Benin. This was a prospective interventional study comprising an HIIT programme executed on a recumbent bike, three times/week, 20-30 min/session for 6 weeks, added to a conventional physiotherapy. The primary outcomes were feasibility, credibility and expectancy assessed with credibility and expectancy questionnaire. A maximal exercise test, 6-min walking test (6MWT), 10-m walking test (10mWT), Berg balance scale (BBS) and five repetitions sit-to-stand test (5 R-STS) were performed before and after the training programme. Ten outpatients, with a median age [P25-P75]: 63.5[56.7-71.2] years; time since stroke: 15.0[9.7-21.0] days, started and completed all training sessions without serious adverse events. High scores were observed on the Credibility subscale at admission (27.0[25.7-27.0]), which remained so after intervention (26.5[25.7-27.0]). Expectancy subscale scores were high at admission (25.5[24.0-27.0]) and post-training (25.5[24.5-27.0]). Peak workload (p < 0.001), BBS (p < 0.001), 6MWT (p < 0.001), 10mWT (p < 0.001) and 5 R-STS (p = 0.004) were all improved. HIIT is feasible and safe in the early subacute post-stroke stage and is perceived by patients as highly credible, meeting their expectations of recovery.
Assuntos
Estudos de Viabilidade , Treinamento Intervalado de Alta Intensidade , Reabilitação do Acidente Vascular Cerebral , Humanos , Benin , Pessoa de Meia-Idade , Reabilitação do Acidente Vascular Cerebral/métodos , Masculino , Estudos Prospectivos , Treinamento Intervalado de Alta Intensidade/métodos , Idoso , Feminino , Equilíbrio Postural/fisiologia , Teste de Esforço , Países em Desenvolvimento , Resultado do Tratamento , Teste de CaminhadaRESUMO
BACKGROUND AND OBJECTIVE: Physiotherapy is highly recommended for early recovery from stroke. This study aimed to document physiotherapy practices for people with acute and early sub-acute stroke in Benin. METHODS: In this prospective observational study, physiotherapists working with acute stroke people documented the content of their treatment from six hospitals in Benin during the first session, at 2-week, and 1-month post-stroke with a standardized physiotherapy documentation form. We used the motricity index (MI) and trunk control test (TCT) to assess impairments, and the 10-meter walk test (10mWT), functional independence measure (FIM), walking, stair climbing, and dressing upper body subscales were used for activity limitations. RESULTS: Fifteen physiotherapists (60 % male, mean±SD age=31.3±5.8 years) recorded treatment sessions for 77 stroke participants (53.2 % male, mean±SD age=57.7±12.5 years). Physiotherapists focused on conventional physiotherapy approaches, including musculoskeletal (67 % of pre-functional activity time) and neuromuscular (53 % of sitting activity time) interventions. A significant difference was found between the therapy time delivered for people with mild, moderate, and severe stroke (p < 0.001). The MI (p= 0.033) and TCT (p= 0.002) measures showed significant improvement at 2-week and 1-month (p< 0.001) post-stroke, while 10mWT, FIM walking, stair climbing, and dressing upper body items significantly increased at 1-month (p< 0.001) but not at 2-week post-stroke. CONCLUSION: Physiotherapists working with acute stroke patients in Benin mainly use conventional neuromuscular and musculoskeletal interventions. In contrast, aerobic exercises were rarely employed regardless of stroke severity. Furthermore, our findings showed that the volume of physiotherapy sessions varied by stroke severity.
RESUMO
To appraise available International Classification of Functioning, Disability and Health (ICF)-based tools for the measurement of participation after stroke and to examine their applicability in the African sociocultural context. Pubmed/Medline, Science Direct, Cochrane Library, and Hinari databases were systematically searched. The literature search was limited to studies published in the English or French language from January 2001 up to May 2019. Two reviewers independently screened all identified studies and selected eligible articles. Disagreements about inclusion or exclusion of studies were resolved by consensus. Two reviewers independently extracted the psychometric properties of each instrument using the Consensus-based Standard for the Selection of Health Measurement Instruments checklist and examined the methodological quality of each selected study using the MacDermid checklist. A total of 1030 articles were systematically reviewed for relevance, yielding 22 studies that met inclusion criteria. These studies were related to nine participation tools. The MacDermid scores ranged from 13 to 21 out of 24. The number of investigated psychometric properties and the number of ICF participation domains covered by each tool varied among studies. This systematic review revealed nine ICF-based tools for the measurement of participation after stroke. We examined the content of these tools and provided valuable information that can be used to guide researchers in Africa in their selection of the most appropriate tool for the measurement of participation after stroke.