Susan Marzolini1,2,3, Dina Brooks1,2,3, Paul Oh1,3, David Jagroop1,4, Bradley J MacIntosh3,5, Nicole D Anderson2,3,6, David Alter1,7, Dale Corbett3,8. 1. 1 Toronto Rehab-University Health Network, Toronto, ON, Canada. 2. 2 University of Toronto, Toronto, ON, Canada. 3. 3 Canadian Partnership for Stroke Recovery. 4. 4 University of Ontario Institute of Technology, Oshawa, ON, Canada. 5. 5 Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 6. 6 Rotman Research Institute, Baycrest Health Sciences, Toronto, ON. 7. 7 Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. 8. 8 University of Ottawa, Ottawa, Canada.
Abstract
BACKGROUND: Stroke is associated with muscle atrophy and weakness, mobility deficits, and cardiorespiratory deconditioning. Aerobic and resistance training (AT and RT) each have the potential to improve deficits, yet there is limited evidence on the utility of combined training. OBJECTIVE: To examine the effects of AT+RT versus AT on physiological outcomes in chronic stroke with motor impairments. METHODS:Participants (n = 73) were randomized to 6 months of AT (5 d/wk) or AT+RT (3 and 2 d/wk, respectively). Outcomes included those related to body composition by dual-energy X-ray absorptiometry, mobility (6-minute walk distance [6MWD], sit-to-stand, and stair climb performance), cardiorespiratory fitness (VO2peak, oxygen uptake at the ventilatory threshold [VO2VT]), and muscular strength. RESULTS:A total of 68 (93.2%) participants (age, mean ± SD = 63.7 ± 11.9) completed the study. AT+RT and AT yielded similar and significant improvements in 6MWD (39.9 ± 55.6 vs 36.5 ± 63.7 m, P = .8), VO2peak (16.4% ± 43.8% vs 15.2% ± 24.7%, P = .9), sit-to-stand time (-2.3 ± 5.1 vs 1.02 ± 9.5 s, P = .05), and stair climb performance (8.2% ± 19.6% vs 7.5% ± 23%, P = .97), respectively. AT+RT produced greater improvements than AT alone for total body lean mass (1.23 ± 2.3 vs 0.27 ± 1.6 kg, P = .039), predominantly trunk ( P = .02) and affected-side limbs ( P = .04), VO2VT (19.1% ± 26.8% vs 10.5% ± 28.9%, P = .046), and upper- and lower-limb muscular strength ( P < .03, all except affected-side leg). CONCLUSION: Despite being prescribed 40% less AT, AT+RT resulted in similar and significant improvement in mobility and VO2peak, superior improvements in VO2VT and muscular strength, and an almost 5-fold greater increase in lean mass compared with AT. RT is the most neglected exercise component following stroke but should be prescribed with AT for metabolic, cardiorespiratory, and strength recovery.
RCT Entities:
BACKGROUND:Stroke is associated with muscle atrophy and weakness, mobility deficits, and cardiorespiratory deconditioning. Aerobic and resistance training (AT and RT) each have the potential to improve deficits, yet there is limited evidence on the utility of combined training. OBJECTIVE: To examine the effects of AT+RT versus AT on physiological outcomes in chronic stroke with motor impairments. METHODS:Participants (n = 73) were randomized to 6 months of AT (5 d/wk) or AT+RT (3 and 2 d/wk, respectively). Outcomes included those related to body composition by dual-energy X-ray absorptiometry, mobility (6-minute walk distance [6MWD], sit-to-stand, and stair climb performance), cardiorespiratory fitness (VO2peak, oxygen uptake at the ventilatory threshold [VO2VT]), and muscular strength. RESULTS: A total of 68 (93.2%) participants (age, mean ± SD = 63.7 ± 11.9) completed the study. AT+RT and AT yielded similar and significant improvements in 6MWD (39.9 ± 55.6 vs 36.5 ± 63.7 m, P = .8), VO2peak (16.4% ± 43.8% vs 15.2% ± 24.7%, P = .9), sit-to-stand time (-2.3 ± 5.1 vs 1.02 ± 9.5 s, P = .05), and stair climb performance (8.2% ± 19.6% vs 7.5% ± 23%, P = .97), respectively. AT+RT produced greater improvements than AT alone for total body lean mass (1.23 ± 2.3 vs 0.27 ± 1.6 kg, P = .039), predominantly trunk ( P = .02) and affected-side limbs ( P = .04), VO2VT (19.1% ± 26.8% vs 10.5% ± 28.9%, P = .046), and upper- and lower-limb muscular strength ( P < .03, all except affected-side leg). CONCLUSION: Despite being prescribed 40% less AT, AT+RT resulted in similar and significant improvement in mobility and VO2peak, superior improvements in VO2VT and muscular strength, and an almost 5-fold greater increase in lean mass compared with AT. RT is the most neglected exercise component following stroke but should be prescribed with AT for metabolic, cardiorespiratory, and strength recovery.
Entities:
Keywords:
aerobic exercise; body composition; cardiorespiratory fitness; exercise; resistance training
Authors: Jelena Toma; Brittany Hammond; Vito Chan; Alex Peacocke; Baharak Salehi; Prateek Jhingan; Dina Brooks; Andrée-Anne Hébert; Susan Marzolini Journal: CJC Open Date: 2020-02-10
Authors: Matthew W McDonald; Matthew S Jeffers; Lama Issa; Anthony Carter; Allyson Ripley; Lydia M Kuhl; Cameron Morse; Cesar H Comin; Bernard J Jasmin; Baptiste Lacoste; Dale Corbett Journal: Neurorehabil Neural Repair Date: 2021-04-07 Impact factor: 3.919
Authors: Azadeh Barzideh; Susan Marzolini; Cynthia Danells; David Jagroop; Andrew H Huntley; Elizabeth L Inness; Sunita Mathur; George Mochizuki; Paul Oh; Avril Mansfield Journal: BMJ Open Date: 2020-06-30 Impact factor: 2.692
Authors: Susan Marzolini; Che-Yuan Wu; Rowaida Hussein; Lisa Y Xiong; Suban Kangatharan; Ardit Peni; Christopher R Cooper; Kylie S K Lau; Ghislaine Nzodjou Makhdoom; Maureen Pakosh; Stephanie A Zaban; Michelle M Nguyen; Mohammad Amin Banihashemi; Walter Swardfager Journal: J Am Heart Assoc Date: 2021-12-16 Impact factor: 6.106
Authors: Lais Manata Vanzella; Gabriela Lima de Melo Ghisi; Tracey Jacqueline Fitchett Colella; Jillian Larkin; Luiz Carlos Marques Vanderlei; Susan Marzolini; Scott Thomas; Paul Oh Journal: J Clin Med Date: 2022-08-18 Impact factor: 4.964