Abstract
Introduction: Declines in cardiovascular function in individuals following stroke result in increased energy costs of movement, restrictions in participation, and increased risk for recurrent stroke and other cardiovascular diseases. We have developed a rehabilitation model that incorporates aerobic exercise training to harness its potential neuroplastic effects. Our aim is to identify the cardiovascular benefits from a forced-rate aerobic exercise (FE) intervention among individuals with chronic stroke compared to an upper extremity repetitive task practice (UE RTP) control group. Hypothesis: We hypothesized that FE would elicit greater improvements in cardiovascular fitness compared to the UE RTP intervention. Methods: A randomized clinical trial was conducted in which participants (N=60) completed 24 sessions over 8 weeks of FE followed by RTP (FE+RTP) or time-matched RTP alone. The FE+RTP group exercised at 60-80% of heart rate reserve on a motorized stationary semi-recumbent cycle ergometer for 45 minutes followed by 45 minutes of RTP. The control group completed 90 minutes of RTP. Metabolic exercise stress tests were conducted at baseline and post-intervention. Outcomes included peak oxygen consumption (peak VO2) and anaerobic threshold (AT). Results: Fifty participants completed the study intervention and pre/post stress tests. The FE+RTP group demonstrated significantly greater improvements in peak VO2 from 16.4±5.7 to 18.3±6.4 mL/min/kg compared to the RTP group (17.0±5.6 to 17.2±5.6 mL/min/kg, p=0.020) and significantly greater improvements in AT from 10.3±2.8 to 11.5±3.6 mL/min/kg compared to the RTP group (10.8±3.9 to 10.4±3.2 mL/min/kg, p=0.020). Conclusions: An aerobic exercise intervention integrated into rehabilitation was effective in eliciting significant and meaningful improvements in cardiovascular fitness. This novel rehabilitation model may be an effective approach to improve motor and cardiovascular function.
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