Aerobic exercise and consecutive task-specific training (AExaCTT) for upper limb recovery after stroke: A randomized controlled pilot study.

Abstract

This study examined the feasibility of a parallel-group assessor-blinded randomized controlled trial investigating whether task-specific training preceded by aerobic exercise (AEX+TST) improves upper limb function more than task-specific training (TST) alone. People with upper limb motor dysfunction after stroke were allocated to TST or AEX+TST. Both groups were prescribed 60hr of TST over 10weeks (3×1-hr sessions with a therapist per week and 3×1hr of home-based self-practice per week). The AEX+TST group performed 30minutes of aerobic exercise immediately prior to the 1hr of TST with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events were recorded. Clinical measures were performed prerandomization at baseline, on completion of the intervention, and at 1- and 6-month follow-up. Fifty-nine persons after stroke were screened, 42 met the eligibility criteria, and 20 (11 male; mean [SD] age: 55.4 [16.0] years; time since stroke: 71.7 [91.2] months) were recruited over 17months. The mean Wolf Motor Function Test Functional Ability Score at baseline was 27.4 (max=75) and the mean Action Research Arm Test score was 11.2 (max=57). Nine were randomized to AEX+TST and 11 to TST. There were no adverse events, but there was one drop out. Retention at 1- and 6-month follow-up was 80% and 85%, respectively. Attendance was 93% (6) for the AEX+TST group, and 89% (9) for the TST group. AEX+TST was perceived as acceptable (100%) and beneficial (87.5%). Exertional fatigue (visual analogue scale) prior to TST was worse in the AEX+TST group (3.5 [0.7] out of 10) than the TST group (1.7 [1.4] out of 10). The TST group performed 31% more repetitions per session than the AEX+TST group. A subsequent Phase III study is feasible, but modifications to eligibility criteria, outcome measures, and intervention delivery are recommended.