Task-Oriented Circuit Training as an Alternative to Ergometer-Type Aerobic Exercise Training after Stroke.

Liam P Kelly,Augustine J Devasahayam,Marie E Curtis,Fabien A Basset,Michelle Ploughman,Jason Mccarthy,Arthur R Chaves,Edward W Randell

doi:10.3390/jcm10112423

Liam P Kelly, Augustine J Devasahayam + Show 6 more

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https://doi.org/10.3390/jcm10112423

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Abstract

Moderate-intensity aerobic exercise training is an important treatment strategy to enhance functional recovery and decrease cardiometabolic risk factors after stroke. However, stroke related impairments limit access to ergometer-type exercise. The aims of the current study were (1) to evaluate whether our task-oriented circuit training protocol (intermittent functional training; IFT) could be used to sustain moderate-intensity aerobic workloads over a 10-week intervention period, and (2) to investigate its preliminary effects on cardiorespiratory fitness and metabolic profiles compared to constant-load ergometer-type exercise (CET). Forty chronic hemiparetic stroke survivors were randomized to receive 30 sessions of IFT or CET over ten weeks. Similar proportions of participants were randomized to IFT (7/19) and CET (9/18) sustained workloads associated with moderate-intensity aerobic exercise over the study period (p = 0.515). However, CET was associated with more substantial changes in maximal oxygen uptake (MD = 2.79 mL min−1 kg−1 CI: 0.84 to 4.74) compared to IFT (MD = 0.62 mL min−1 kg−1 CI: −0.38 to 1.62). Pre to post changes in C-reactive protein (−0.9 mg/L; p =0.017), short-term glycemia (+14.7 µmol/L; p = 0.026), and resting whole-body carbohydrate oxidation (+24.2 mg min−1; p = 0.046) were observed when considering both groups together. Accordingly, IFT can replicate the aerobic intensities sustained during traditional ergometer-type exercise training. More work is needed to evaluate the dose–response effects of such task-oriented circuit training protocols on secondary prevention targets across the continuum of stroke recovery.

Highlights

Stroke rehabilitative efforts are primarily directed toward the recovery of lost functions.best practice guidelines include 15 h of direct task-oriented therapy each week during inpatient/outpatient rehabilitation services [1]
Practitioners are recommended to incorporate an additional min of moderate-intensity aerobic exercise each week during formalized care and encourage stroke survivors to remain active throughout the continuum of recovery [3,4]
Building on previous literature [17,18], we developed a task-oriented circuit training protocol that included activities typically employed during formalized stroke rehabilitation and did not require the use of ergometers or other specialized equipment

Summary

Introduction

Best practice guidelines include 15 h of direct task-oriented therapy each week during inpatient/outpatient rehabilitation services [1]. Practitioners are recommended to incorporate an additional min of moderate-intensity aerobic exercise each week during formalized care and encourage stroke survivors to remain active throughout the continuum of recovery [3,4]. Recent evidence suggests an increased focus on incorporating aerobic exercise recommendations during formalized stroke rehabilitation [7], sedentary activities remain the dominant behavior of the inpatient environment [8,9,10,11,12]. Practical solutions are needed to increase access to moderate-intensity aerobic exercise throughout the continuum of stroke recovery

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