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

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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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