Abstract TMP28: Forced-Rate Aerobic Cycling Enhances Motor Recovery in Persons With Chronic Stroke: A Randomized Clinical Trial

Abstract

Introduction: The potential for intensive aerobic exercise to enhance neuroplasticity post-stroke has been theorized but not systematically investigated. Our aim was to determine the effects of forced-rate aerobic exercise paired with an abbreviated session of upper extremity (UE) repetitive task practice (FE+RTP) compared to time-matched UE repetitive task practice (RTP only) on the recovery of motor function in individuals with chronic stroke. Hypothesis: We hypothesized that FE+RTP would yield greater improvements in UE motor recovery compared to time-matched RTP only. Methods: A randomized clinical trial was conducted in which participants (N=60) completed 24 sessions 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. The primary UE outcomes were the Fugl-Meyer Assessment (FMA) and the Action Research Arm Test (ARAT). The Six-minute Walk Test (6MWT) assessed walking capacity. Results: Sixty individuals 60.5 (±10.6) years of age were enrolled, and 56 completed the study. The RTP only group completed more RTP in terms of repetitions (411.8±44.4 versus 222.8±28.4, P<0.001) and time (72.7±6.7 versus 37.8±2.4 minutes, P<0.001) compared to FE+RTP. Both groups improved on the FMA (FE+RTP, 36.2±10.1 to 44.0±11.8 and RTP only, 34.4±11.0 to 41.2±13.4, P<0.001) and ARAT (FE+RTP, 32.5±16.6 to 37.7±17.9 and RTP only, 32.8±18.6 to 36.4±18.5, P<0.001). A group main effect was not observed. The FE+RTP group demonstrated greater improvements on the 6MWT (274.9±122.0 to 327.1±141.2 meters) compared to the RTP only group (285.5±160.3 to 316.9±170.0, P=0.004). Conclusions: While both interventions elicited comparable improvements in UE motor recovery, the summative value of FE+RTP in improving UE and lower extremity function was demonstrated.