Intensive aerobic cycling training with lower limb weights in Chinese patients with chronic stroke: discordance between improved cardiovascular fitness and walking ability

Jin, Hong; Jiang, Yibo; Qin, Wei; Wang, Bilei; Ma, Genshan

doi:10.3109/09638288.2012.658952

Cited by 24 publications

(15 citation statements)

References 32 publications

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“…Four RCTs included 3 or 4 training groups in their design [ 38 ],[ 53 ],[ 58 ],[ 59 ]. Twenty-nine studies (78.4%) included chronic stroke survivors [ 32 ]–[ 41 ],[ 43 ],[ 44 ],[ 46 ]–[ 54 ],[ 58 ]–[ 65 ], 5 (13.5%) included sub-acute stroke survivors [ 29 ]–[ 31 ],[ 55 ],[ 56 ] whilst 3 studies (8.1%) included both types of patients [ 42 ],[ 45 ],[ 57 ]. In the 18 studies evaluating aerobic exercise only (n = 1278) [ 29 ]–[ 46 ], treadmill training with or without body weight support was the most frequently used exercise intervention.…”

Section: Resultsmentioning

confidence: 99%

“…One study described all six principles of exercise training [ 32 ], one described 5 out of 6 [ 47 ], 11 described 4 out of 6 [ 34 ],[ 36 ],[ 37 ],[ 40 ],[ 41 ],[ 43 ],[ 44 ],[ 46 ],[ 53 ],[ 58 ],[ 60 ] and 12 described three training principles [ 30 ],[ 35 ],[ 38 ],[ 39 ],[ 49 ],[ 51 ],[ 59 ],[ 61 ]–[ 64 ] (Additional file 2 : Table S1a-c). The remaining 12 studies, representing 32.4% of the included studies, described just one [ 42 ],[ 48 ],[ 50 ],[ 57 ] or two [ 29 ],[ 31 ],[ 33 ],[ 45 ],[ 52 ],[ 54 ]–[ 56 ],[ 65 ] of these.…”

Section: Resultsmentioning

confidence: 99%

“…The remaining 12 studies, representing 32.4% of the included studies, described just one [ 42 ],[ 48 ],[ 50 ],[ 57 ] or two [ 29 ],[ 31 ],[ 33 ],[ 45 ],[ 52 ],[ 54 ]–[ 56 ],[ 65 ] of these. With respect to the specific training principles, 33 (89.2%) of the RCTs reported specificity [ 30 ],[ 32 ],[ 34 ]–[ 56 ],[ 58 ]–[ 65 ], 28 (75.7%) described progression [ 32 ]–[ 41 ],[ 43 ],[ 44 ],[ 46 ],[ 47 ],[ 49 ],[ 51 ]–[ 53 ],[ 55 ],[ 56 ],[ 58 ]–[ 65 ], 18 (48.7%) described overload [ 32 ],[ 34 ]–[ 37 ],[ 39 ],[ 40 ],[ 43 ],[ 44 ],[ 46 ],[ 47 ],[ 49 ],[ 53 ],[ 58 ]–[ 60 ],[ 63 ],[ 64 ], 14 (37.8%) described initial values [ 29 ]–[ 32 ],[ 40 ],[ 41 ],[ 43 ]–[ 47 ],[ 53 ],[ 57 ],[ 60 ], 12 (32.4%) described reversibility [ 29 ],[ 31 ]–[ 34 ],[ 38 ],[ 41 ],[ 47 ],[ 51 ],[ 54 ],[ …”

Section: Resultsmentioning

confidence: 99%

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Application of principles of exercise training in sub-acute and chronic stroke survivors: a systematic review

et al. 2014

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BackgroundThere is increasing evidence for the beneficial effects of exercise training in stroke survivors. In order to reach the desired training effects, exercise training principles must be considered as this ensures the prescription of adequate exercises at an adequate dose. Moreover, exercise training interventions must be designed in a way that maximizes patients’ adherence to the prescribed exercise regimen. The objectives of this systematic review were (1) to investigate whether training principles for physical exercise interventions are reported in RCTs for sub-acute and chronic stroke survivors, (2) to evaluate whether the RCTs reported the prescription of the FITT components of the exercise interventions as well as (3) patients’ adherence to this prescription, and (4) to assess the risk of bias of the included studies.MethodsWe performed a systematic review of RCTs with exercise training as the primary intervention and muscular strength and/or endurance as primary outcomes. The Cochrane library’s risk of bias (ROB) tool was used to judge the methodological quality of RCTs.ResultsThirty-seven RCTs were included in this systematic review. Eighteen studies (48.7%) focused on aerobic, 8 (21.6%) on resistance and 11 (29.7%) on combined interventions of aerobic and resistive strength exercise. Twenty-nine studies (78.4%) included only chronic stroke survivors, 5 studies (13.5%) only sub-acute stroke survivors whilst 3 studies (8.1%) included both. In terms of principle of exercise training, 89% reported specificity, 75.7% progression, 48.7% overload, 37.8% initial values, 32.4% reversibility and 13.5% diminishing returns. One RCT described all principles of physical exercise training and 19 (51.4%) all FITT components. Patients’ adherence to exercise prescription was accounted for in 3 studies (8.1%). Failure to report blinding in patients and participants and failure to report allocation concealment were the most prevalent methodological shortcomings.ConclusionsIncomplete and inconsistent reporting of (1) training components, (2) underlying exercise training principles and (3) patient adherence together with (4) a broad variation in the methodological quality of the included RCTs limit both the utility and reproducibility of physical exercise programs in stroke patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Application of principles of exercise training in sub-acute and chronic stroke survivors: a systematic review

et al. 2014

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“…For example, the interventions in the balance and/or functional weight-shifting group varied from circuit class training focusing on agility and dynamic balance control 34 to hydrotherapy-based tai-chi exercises. 35 Similarly, the control interventions were heterogeneous in nature as well. Because of this heterogeneity within the relatively small number of studies per group (n=8 for balance and/or functional weight-shifting training and n=10 for gait training), it is not possible to determine whether all forms of balance, functional weight-shifting, or gait exercises included in these categories were equally effective.…”

Section: Discussionmentioning

confidence: 99%

Effects of Exercise Therapy on Balance Capacity in Chronic Stroke

Duijnhoven¹,

Heeren²,

Peters

et al. 2016

Stroke

113

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A fter stroke, a main goal of rehabilitation is to promote independence in activities of daily living. An important determinant of activities of daily living performance is standing balance, which is a strong predictor of functional recovery 1,2 and walking capacity 3,4 and an important risk factor for falls 5 after stroke. Although the vast majority (75%) of people after stroke regain independent standing-balance capacity, 6 weightbearing asymmetry and increased postural sway often persist, as well as a diminished capacity to voluntarily shift body weight or to withstand external perturbations. 7 Hence, a keyBackground and Purpose-The purpose of this systematic review and meta-analysis was to investigate the effects of exercise training on balance capacity in people in the chronic phase after stroke. Furthermore, we aimed to identify which training regimen was most effective. Methods-Electronic databases were searched for randomized controlled trials evaluating the effects of exercise therapy on balance capacity in the chronic phase after stroke. Studies were included if they were of moderate or high methodological quality (PEDro score ≥4). Data were pooled if a specific outcome measure was reported in at least 3 randomized controlled trials. A sensitivity analysis and consequent subgroup analyses were performed for the different types of experimental training (balance and/or weight-shifting training, gait training, multisensory training, high-intensity aerobic exercise training, and other training programs). Results-Forty-three randomized controlled trials out of 369 unique hits were included. A meta-analysis could be conducted for the Berg Balance Scale (28 studies, n=985), Functional Reach Test (5 studies, n=153), Sensory Organization Test (4 studies, n=173), and mean postural sway velocity (3 studies, n=89). A significant overall difference in favor of the intervention group was found for the Berg Balance Scale (mean difference 2. Previous meta-analyses of the effects of exercise therapy on improving balance capacity have been inconclusive. [8][9][10][11] There seemed to be an effect of biofeedback training on postural sway and of repetitive task training on sit-to-stand activities, 8 but both types of training did not result in better performance on clinical tests of balance capacity. 9 In addition, it remained unclear which type of training regimen would be most effective. Furthermore, previous meta-analyses did not address whether training effects differed between poststroke stages. One systematic review reported that favorable effects of balance exercises were restricted to the chronic phase (≥6 months post onset), but a meta-analysis was not included to substantiate this statement. 12Nevertheless, several studies that have been published since suggest that exercise therapy may yield significant improvements in balance capacity in individuals in the chronic phase of stroke. 13,14 Evaluating the effects of exercise therapy in the chronic phase of stroke is of particular interest because the resu...

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“…The equation utilized to detect brain activity was mean values of mean frequency of [(delta + theta)/ (alpha + beta)] ratio [5]. The transitions from extension to flexion (and vice versa) during walking may be the most vulnerable locomotor function to be impaired after stroke [6].…”

Section: Introductionmentioning

confidence: 99%

Effect of cycling exercise on motor excitability and gait abnormalities in stroke patients

El-Tamawy

Darwish

Basheer

et al. 2021

Egypt J Neurol Psychiatry Neurosurg

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Background The concepts of brain excitability are still re-wiring in response to changes in environment. Ambulation is often limited in stroke patients. Objective To determine the effect of cycling exercise on motor excitability and consequences on spatiotemporal gait parameters in stroke patients. Methods Forty male ischemic stroke patients were included; their age ranged from 45 to 60 years. The patients were assigned into two equal groups: control group (GI) and study group (GII). The GI is treated by a design physical therapy program in the form of task-oriented progressive resistance exercise for lower limb muscles, and the GII is treated by the same program in addition to cycling exercise for 30 min. Treatment was conducted three times per week for 10 weeks. The excitability over motor area (Cz) was assessed by the quantitative electroencephalogram (QEEG). The spatiotemporal gait parameters were assessed by the Biodex Gait Trainer 2TM. Results There was a significant increase of speed, step cycle, and step length of the affected side (P < 0.05) and a non-significant difference of step length of the non-affected side in the study group compared with that of the control group (P > 0.05). There was a significant increase of excitability over motor area (Cz) in the study group compared with that of the control group (P < 0.05). Conclusion Cycling exercise has a positive effect on excitability over motor area of lower limbs and can improve gait parameters in stroke patients.

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Intensive aerobic cycling training with lower limb weights in Chinese patients with chronic stroke: discordance between improved cardiovascular fitness and walking ability

Abstract: The enhanced cardiovascular fitness after aerobic cycling training in Chinese patients with chronic stroke is not associated with the increased walking ability. Unparallel improvements in these parameters related different determinants may have implications for intervention strategy.

Cited by 24 publications

References 32 publications

Application of principles of exercise training in sub-acute and chronic stroke survivors: a systematic review

Application of principles of exercise training in sub-acute and chronic stroke survivors: a systematic review

Effects of Exercise Therapy on Balance Capacity in Chronic Stroke

Effect of cycling exercise on motor excitability and gait abnormalities in stroke patients

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