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Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors.


ABSTRACT: Objective: To determine whether stroke survivors could maintain workloads during functional task practice that can reach moderate levels of cardiometabolic stress (i.e., ?40% oxygen uptake reserve ([Formula: see text]O2R) for ?20 min) without the use of ergometer-based exercise. Design: Cross-sectional study using convenience sampling. Setting: Research laboratory in a tertiary rehabilitation hospital. Participants: Chronic hemiparetic stroke survivors (>6-months) who could provide consent and walk with or without assistance. Intervention: A single bout of intermittent functional training (IFT). The IFT protocol lasted 30 min and involved performing impairment specific multi-joint task-oriented movements structured into circuits lasting ~3 min and allowing 30-45 s recovery between circuits. The aim was to achieve an average heart rate (HR) 30-50 beats above resting without using traditional ergometer-based aerobic exercise. Outcome measures: Attainment of indicators for moderate intensity aerobic exercise. Oxygen uptake ([Formula: see text]O2), carbon dioxide production ([Formula: see text]CO2), and HR were recorded throughout the 30 min IFT protocol. Values were reported as percentage of [Formula: see text]O2R, HR reserve (HRR) and HRR calculated from predicted maximum HR (HRRpred), which were determined from a prior maximal graded exercise test. Results: Ten (3-female) chronic (38 ± 33 months) stroke survivors (70% ischemic) with significant residual impairments (NIHSS: 3 ± 2) and a high prevalence of comorbid conditions (80% ? 1) participated. IFT significantly increased all measures of exercise intensity compared to resting levels: [Formula: see text]O2 (? 820 ± 290 ml min-1, p < 0.001), HR (? 42 ± 14 bpm, p < 0.001), and energy expenditure (EE; ? 4.0 ± 1.4 kcal min-1, p < 0.001). Also, mean values for percentage of [Formula: see text]O2R (62 ± 19), HRR (55 ± 14), and HRRpred (52 ± 18) were significantly higher than the minimum threshold (40%) indicating achievement of moderate intensity aerobic exercise (p = 0.004, 0.016, and 0.043, respectively). Conclusion: Sufficient workloads to achieve moderate levels of cardiometabolic stress can be maintained in chronic stroke survivors using impairment-focused functional movements that are not dependent on ergometers or other specialized equipment.

SUBMITTER: Kelly LP 

PROVIDER: S-EPMC5662635 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors.

Kelly Liam P LP   Devasahayam Augustine J AJ   Chaves Arthur R AR   Wallack Elizabeth M EM   McCarthy Jason J   Basset Fabien A FA   Ploughman Michelle M  

Frontiers in physiology 20171026


<b>Objective:</b> To determine whether stroke survivors could maintain workloads during functional task practice that can reach moderate levels of cardiometabolic stress (i.e., ≥40% oxygen uptake reserve ([Formula: see text]O<sub>2</sub>R) for ≥20 min) without the use of ergometer-based exercise. <b>Design:</b> Cross-sectional study using convenience sampling. <b>Setting:</b> Research laboratory in a tertiary rehabilitation hospital. <b>Participants:</b> Chronic hemiparetic stroke survivors (>6-  ...[more]

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