Effectiveness of hospital-based low intensity and inspected aerobic training on functionality and cardiorespiratory fitness in unconditioned stroke patients: Importance of submaximal aerobic fitness markers

Abstract

Introduction: The purpose of our study was to evaluate the effectiveness of low-to moderate intensity aerobic training on cardiorespiratory functions in chronic unconditioned stroke patients. The oxygen uptake efficiency slope (OUES) and the ventilatory threshold (VO 2 -VT) could represent the aerobic capacity in submaximal test. Our study examined the application of the submaximal parameters for evaluating aerobic capacity of chronic stroke patients. Materials and methods: In our assessor-blinded controlled pilot study 37 patients were randomized into 2 groups named: intervention group (IG, n: 21) and control group (CG, n:16), respectively. Cardiorespiratory functions were evaluated by ergospirometer before and after the 4-week (20 days) program. Both groups participated in daily occupational therapy (30 minutes) and conventional, customized physiotherapy CG (60 minutes), IG (30 minutes). Only IG performed aerobic training by bicycles (30 minutes) aiming to reach low-to moderate training intensity. Outcome measures included peak oxygen uptake (VO 2 peak), OUES, VO 2 -VT, functional exercise capacity 6-Minute Walking Test (6MWT) and Functional Independence Measure. Results: Thirty-five subjects completed the study. The VO 2 peak uptake was very low in both groups (IG: 11.9 mL/kg/min, CG: 12.45 mL/kg/min) and did not improve after the program, but submaximal parameters such as VO 2 -VT ( P < .01) and OUES ( P < .001) have shown significant improvement, but only in IG regardless of insufficient impact on VO 2 peak. Each participant in both groups was unable to permanently reach the moderate intensity zone. Functional Independence Measure changed for the better in both groups, but 6MWT only in the IG. Discussion and Conclusions: Four-week exercise training even at low intensity by lower limb cycle ergometer may provide benefit on aerobic and functional capacity without improvement of VO 2 peak on unconditioned chronic stroke patients.

Aerobic exercise interventions for promoting cardiovascular health and mobility after stroke: a systematic review with Bayesian network meta-analysis

“…The common aerobic intervention groups included MICT (n=22 arms),17 53–73 high-intensity continuous training (HICT) (n=23 arms),61 68 74–94 HIIT (n=8 arms)17 54 60 65 67 95–97 and low (n=5 arms) 63 69 74 80 88. The most common comparator was usual care (n=31 arms)53 55 57–59 62 64 65 70–73 75 78 79 81–87 89–93 95–98 which commonly included components of stroke rehabilitation such as gait retraining, active or passive range of motion, stretching, light resistance training, balance, functional training or education on physical activity, lifestyle and medication modifications and no exercise (n=4 arms) 56 66 76 94. Briefly, sample size ranged from 5 to 105 participants (mean age range, 48–76 years; one study did not report the mean age of participants76), and study duration ranged from 3 to 24 weeks.…”