BACKGROUND AND OBJECTIVE:Ambulatory subjects after stroke may benefit from gait-oriented cardiovascular fitness training, but trials to date have not primarily assessed older persons. METHODS:Thirty-eight subjects (age >60 years) with residual hemiparetic gait were enrolled >6 months after stroke. Participants were randomized to receive 3 months (3×/week) progressive graded, high-intensity aerobic treadmill exercise (TAEX) or conventional care physiotherapy. Primary outcome measures were peak exercise capacity (Vo(2peak)) and sustained walking capacity in 6-minute walks (6MW). Secondary measures were gait velocity in 10-m walks, Berg Balance Scale, functional leg strength (5 chair-rise), self-rated mobility (Rivermead Mobility Index), and quality of life (SF-12). RESULTS:Thirty-six participants completed the study (18 TAEX, 18 controls). TAEX but not conventional care improved Vo(2peak) (difference 6.4 mL/kg/min, P < .001) and 6MW (53 m, P < .001). Likewise, maximum walking speed (0.13 m/s, P = .01), balance (P < .05), and the mental subscore of the SF-12 (P < .01) improved more after TAEX. Gains in Vo(2peak) correlated with the degree at which training intensity could be progressed in the individual participant (P < .01). Better walking was related to progression in treadmill velocity and training duration (P < .001). Vo(2peak) and 6MW performances were still higher 1 year after the end of training when compared with the baseline, although endurance walking (6MW) at 1 year was lower than immediately after training (P < .01). CONCLUSION: This trial demonstrates that TAEX effectively improves cardiovascular fitness and gait in persons with chronic stroke.
RCT Entities:
BACKGROUND AND OBJECTIVE: Ambulatory subjects after stroke may benefit from gait-oriented cardiovascular fitness training, but trials to date have not primarily assessed older persons. METHODS: Thirty-eight subjects (age >60 years) with residual hemiparetic gait were enrolled >6 months after stroke. Participants were randomized to receive 3 months (3×/week) progressive graded, high-intensity aerobic treadmill exercise (TAEX) or conventional care physiotherapy. Primary outcome measures were peak exercise capacity (Vo(2peak)) and sustained walking capacity in 6-minute walks (6MW). Secondary measures were gait velocity in 10-m walks, Berg Balance Scale, functional leg strength (5 chair-rise), self-rated mobility (Rivermead Mobility Index), and quality of life (SF-12). RESULTS: Thirty-six participants completed the study (18 TAEX, 18 controls). TAEX but not conventional care improved Vo(2peak) (difference 6.4 mL/kg/min, P < .001) and 6MW (53 m, P < .001). Likewise, maximum walking speed (0.13 m/s, P = .01), balance (P < .05), and the mental subscore of the SF-12 (P < .01) improved more after TAEX. Gains in Vo(2peak) correlated with the degree at which training intensity could be progressed in the individual participant (P < .01). Better walking was related to progression in treadmill velocity and training duration (P < .001). Vo(2peak) and 6MW performances were still higher 1 year after the end of training when compared with the baseline, although endurance walking (6MW) at 1 year was lower than immediately after training (P < .01). CONCLUSION: This trial demonstrates that TAEX effectively improves cardiovascular fitness and gait in persons with chronic stroke.
Authors: Charalambos C Charalambous; Heather Shaw Bonilha; Steven A Kautz; Chris M Gregory; Mark G Bowden Journal: Neurorehabil Neural Repair Date: 2013-06-13 Impact factor: 3.919
Authors: Gabrielle Brazg; Meghan Fahey; Carey L Holleran; Mark Connolly; Jane Woodward; Patrick W Hennessy; Brian D Schmit; T George Hornby Journal: Neurorehabil Neural Repair Date: 2017-10-30 Impact factor: 3.919
Authors: Abigail L Leddy; Mark Connolly; Carey L Holleran; Patrick W Hennessy; Jane Woodward; Ross A Arena; Elliot J Roth; T George Hornby Journal: J Neurol Phys Ther Date: 2016-10 Impact factor: 3.649