理学療法ジャーナル58巻8号

2024年08月発行

特集 全身持久力トレーニング

中枢神経疾患患者に対する全身持久力トレーニング

著者： 小宅一彰¹

所属機関： ¹信州大学医学部保健学科理学療法学専攻

ページ範囲：P.877 - P.884

Point　▶動画

●脳卒中片麻痺患者の全身持久力は，症候限界性漸増運動負荷試験を行い，最高酸素摂取量を測定することで評価する

●脳卒中片麻痺患者における全身持久力の低下には，骨格筋での酸素利用能の低下が主に関連する

●有酸素運動によって，全身持久力の向上だけでなく，脳卒中再発リスクの軽減や日常生活活動の改善も期待できる

＊本論文中，動画マークのある箇所につきましては，関連する動画を見ることができます（公開期間：2027年8月31日）．

参考文献

1）Smith AC, et al：Cardiorespiratory fitness after stroke：a systematic review. Int J Stroke 2012；7：499-510

2）Patterson SL, et al：Determinants of walking function after stroke：differences by deficit severity. Arch Phys Med Rehabil 2007；88：115-119

3）Kim BR, et al：Cardiovascular fitness as a predictor of functional recovery in subacute stroke patients. Disabil Rehabil 2014；36：227-231

4）Thilarajah S, et al：Factors associated with post-stroke physical activity：a systematic review and meta-analysis. Arch Phys Med Rehabil 2018；99：1876-1889

5）Saunders DH, et al：Physical activity and exercise after stroke：review of multiple meaningful benefits. Stroke 2014；45：3742-3747

6）Oyake K, et al：Unilateral arm crank exercise test for assessing cardiorespiratory fitness in individuals with hemiparetic stroke. Biomed Res Int 2017；2017：6862041. doi：10.1155/2017/6862041

7）Oyake K, et al：Cardiorespiratory factors related to the increase in oxygen consumption during exercise in individuals with stroke. PLoS One 2019；14：e0217453. doi：10.1371/journal.pone.0217453

8）Oyake K, et al：Motivational strategies for stroke rehabilitation：a descriptive cross-sectional study. Front Neurol 2020；11：553. doi：10.3389/fneur.2020.00553

9）Oyake K, et al：Motivational strategies for stroke rehabilitation：a Delphi study. Arch Phys Med Rehabil 2020；101：1929-1936

10）Oyake K, et al：Physical therapists use different motivational strategies for stroke rehabilitation tailored to an individual's condition：a qualitative study. Phys Ther 2023；103：pzad034. doi：10.1093/ptj/pzad034

11）Oyake K, et al：A multicenter explanatory survey of patients' and clinicians' perceptions of motivational factors in rehabilitation. Commun Med（Lond） 2023；3：78. doi：10.1038/s43856-023-00308-7

12）Saunders DH, et al：Physical fitness training for stroke patients. Cochrane Database Syst Rev 2020；3：CD003316. doi：10.1002/14651858.CD003316.pub7

13）Wittink H, et al：Measurement properties of maximal cardiopulmonary exercise tests protocols in persons after stroke：a systematic review. J Rehabil Med 2017；49：689-699

14）van de Port IG, et al：Systematic review of cardiopulmonary exercise testing post stroke：are we adhering to practice recommendations? J Rehabil Med 2015；47：881-900

15）Tang A, et al：Cognition and motor impairment correlates with exercise test performance after stroke. Med Sci Sports Exerc 2013；45：622-627

16）Boyne P, et al：Ventilatory threshold may be a more specific measure of aerobic capacity than peak oxygen consumption rate in persons with stroke. Top Stroke Rehabil 2017；24：149-157

17）Billinger SA, et al：Reduced cardiorespiratory fitness after stroke：biological consequences and exercise-induced adaptations. Stroke Res Treat 2012；2012：959120. doi：10.1155/2012/959120

18）Convertino VA：Cardiovascular consequences of bed rest：effect on maximal oxygen uptake. Med Sci Sports Exerc 1997；29：191-196

19）Stoller O, et al：Effects of cardiovascular exercise early after stroke：systematic review and meta-analysis. BMC Neurol 2012；12：45. doi：10.1186/1471-2377-12-45

20）Marsden DL, et al：Characteristics of exercise training interventions to improve cardiorespiratory fitness after stroke：a systematic review with meta-analysis. Neurorehabil Neural Repair 2013；27：775-788

21）Pang MY, et al：Using aerobic exercise to improve health outcomes and quality of life in stroke：evidence-based exercise prescription recommendations. Cerebrovasc Dis 2013；35：7-22

22）Lloyd M, et al：Physical fitness interventions for nonambulatory stroke survivors：a mixed-methods systematic review and meta-analysis. Brain Behav 2018；8：e01000. doi：10.1002/brb3.1000

23）Wang C, et al：Aerobic exercise interventions reduce blood pressure in patients after stroke or transient ischaemic attack：a systematic review and meta-analysis. Br J Sports Med 2019；53：1515-1525

24）Brouwer R, et al：Effect of aerobic training on vascular and metabolic risk factors for recurrent stroke：a meta-analysis. Disabil Rehabil 2021；43：2084-2091

25）MacKay-Lyons M, et al：Aerobic exercise recommendations to optimize best practices in care after stroke：AEROBICS 2019 update. Phys Ther 2020；100：149-156

26）Billinger SA, et al：Physical activity and exercise recommendations for stroke survivors：a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014；45：2532-2553

27）Tang A, et al：Do functional walk tests reflect cardiorespiratory fitness in sub-acute stroke? J Neuroeng Rehabil 2006；3：23. doi：10.1186/1743-0003-3-23

28）Pang MY, et al：Relationship between ambulatory capacity and cardiorespiratory fitness in chronic stroke：influence of stroke-specific impairments. Chest 2005；127：495-501

29）Prajapati SK, et al：Cardiovascular responses associated with daily walking in subacute stroke. Stroke Res Treat 2013；2013：612458. doi：10.1155/2013/612458

30）Moncion K, et al：Barriers and facilitators to aerobic exercise implementation in stroke rehabilitation：a scoping review. J Neurol Phys Ther 2020；44：179-187