Dataset Information

Predictors of Improved Aerobic Capacity in Individuals With Chronic Stroke Participating in Cycling Interventions.

ABSTRACT:

Objective

To determine demographic and physiological factors that predict improvement in aerobic capacity among individuals with chronic stroke participating in cycling interventions.

Design

Secondary analysis of data from 2 randomized clinical trials.

Setting

Research laboratory.

Participants

Individuals with chronic stroke (N=44).

Interventions

Participants were randomized to one of the following interventions: forced aerobic exercise and upper extremity repetitive task practice (FE+UERTP, n=16), voluntary aerobic exercise and upper extremity repetitive task practice (VE+UERTP, n=15), or a nonaerobic control group (control, n=13). All interventions were time-matched and occurred 3 times per week for 8 weeks.

Main outcome measure

Aerobic capacity as measured by peak oxygen consumption per unit time (VO_2peak) during maximal cardiopulmonary exercise stress testing.

Results

Significant improvements in VO_2peak were observed from baseline to postintervention in the VE+UERTP group (P<.001). Considerable variability was observed among participants relating to postintervention change in VO_2peak. Among aerobic exercise participants, a multivariate regression analysis revealed that cycling cadence, baseline VO_2peak, and group allocation were significant predictors of change in VO_2peak.

Conclusions

High exercise rate (cycling cadence) appears to be an important variable in improving aerobic capacity and should be considered when prescribing aerobic exercise for individuals with chronic stroke. Those with low VO_2peak at baseline may benefit the most from aerobic interventions as it relates to cardiorespiratory fitness. Further investigation is warranted to understand the precise role of other exercise and demographic variables in the prescription of aerobic exercise for this population and their effects on secondary stroke prevention and mortality.

SUBMITTER: Linder SM

PROVIDER: S-EPMC7103502 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Predictors of Improved Aerobic Capacity in Individuals With Chronic Stroke Participating in Cycling Interventions.

Linder Susan M SM Davidson Sara S Rosenfeldt Anson A Penko Amanda A Lee John J Koop Mandy Miller MM Phelan Dermot D Alberts Jay L JL

Archives of physical medicine and rehabilitation 20191125 4

<h4>Objective</h4>To determine demographic and physiological factors that predict improvement in aerobic capacity among individuals with chronic stroke participating in cycling interventions.<h4>Design</h4>Secondary analysis of data from 2 randomized clinical trials.<h4>Setting</h4>Research laboratory.<h4>Participants</h4>Individuals with chronic stroke (N=44).<h4>Interventions</h4>Participants were randomized to one of the following interventions: forced aerobic exercise and upper extremity rep ...[more]

PMID: 31778659

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Project description:BackgroundStroke is a highly disabling condition and is the second leading cause of death globally. Engaging in aerobic exercise is important for the prevention of a recurrent stroke through improving markers of cardiovascular health such as blood pressure and arterial stiffness. While higher intensities of aerobic exercise generally elicit greater cardioprotective effects, little is known about the acute cardiovascular effects of a single session of high intensity aerobic exercise in people with stroke. The objective of this study was to model the recovery of arterial stiffness (carotid-femoral pulse wave velocity, cfPWV), heart rate and blood pressure following peak intensity aerobic exercise in individuals with chronic stroke.MethodsTen participants with chronic stroke (mean ± SD age = 56.9 ± 11.8 years, median [IQR] years post-stroke = 2.9 [1.9]) performed a symptom-limited cardiopulmonary exercise test (CPET) on a recumbent stepper. Before the CPET, resting cfPWV, heart rate and blood pressure were measured. Immediately following the CPET, all outcomes were measured again continuously for 20 min to use all available observations (n = 245 observations) and capture any potential non-linear changes. Mixed model analyses were then applied to model post-exercise changes of cfPWV, heart rate and blood pressure.ResultsCarotid-femoral pulse wave velocity was increased from rest following the CPET (9.0 ± 0.53 to 9.9 ± 0.52 m/s, p < 0.001) and remained elevated for 20 min into post-exercise recovery, independent of heart rate (p = 0.001). Heart rate also increased from baseline (71.2 ± 3.2 to 77.4 ± 3.1 bpm, p < 0.001) and remained elevated for 10 min post-exercise (p < 0.001). Finger systolic blood pressure was reduced from rest (117.3 ± 4.7 to 111.8 ± 4.6 mmHg, p < 0.001) and remained reduced for 15 min after exercise (p < 0.001). There were no significant differences in finger diastolic or mean arterial pressures from rest.ConclusionThis was the first study to capture continuous changes in cfPWV following peak aerobic exercise in any clinical population. The present study revealed that cfPWV is elevated for 20 min after peak aerobic exercise in individuals with stroke, which was independent of heart rate. These findings suggest there may be autonomic imbalances in large arteries following peak intensity aerobic exercise in individuals with stroke.

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Dataset Information

Predictors of Improved Aerobic Capacity in Individuals With Chronic Stroke Participating in Cycling Interventions.

Objective

Design

Setting

Participants

Interventions

Main outcome measure

Results

Conclusions

Publications

Predictors of Improved Aerobic Capacity in Individuals With Chronic Stroke Participating in Cycling Interventions.

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