Physical fitness training for stroke patients

Saunders, David H.; Sanderson, Mark; Hayes, Sara; Johnson, Liam; Kramer, Sharon; Carter, Daniel D.; Jarvis, Hannah; Brazzelli, Miriam; Mead, Gillian

doi:10.1002/14651858.cd003316.pub7

Cited by 138 publications

(149 citation statements)

References 357 publications

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“…In addition, a randomised controlled trial reported that the combination of cognitive-behavioural therapy and graded activity training was more effective than cognitive-behavioural therapy alone in treating post-stroke fatigue [44]. Although post-stroke fatigue has a negative impact on the recovery of activities of daily living [5,6], a systematic review reported that aerobic exercise can improve the functional ability in individuals with stroke [11]. Furthermore, at the subacute phase of stroke recovery, several articles demonstrate the effectiveness of exercise in improving health outcomes after stroke including cardiovascular, functional, and mobility outcomes [45,46].…”

Section: Discussionmentioning

confidence: 99%

“…The underlying pathophysiology of post-stroke fatigue is not completely understood, although probable factors include low excitability of the motor cortex and inflammatory responses [1]. In addition, there is insufficient evidence regarding the effectiveness of rehabilitative exercise programmes for improving post-stroke fatigue [1,10], although there is sufficient evidence that exercise training can improve fitness, balance, mobility, and activities of daily living in individuals with stroke [11].…”

Section: Introductionmentioning

confidence: 99%

“…However, there is limited evidence on the association between post-stroke fatigue and cardiorespiratory fitness [12]. Oxygen uptake (V̇O2) at peak exercise measured during a symptom-limited graded exercise test is widely accepted as an indicator of cardiorespiratory capacity in individuals with stroke [11,13,14]. V̇O2 at peak exercise in individuals with stroke is 26%-87% of that in healthy age-and sex-matched individuals [13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ability of The Cardiorespiratory System to Adapt to Exercise is Impaired in Individuals With Severe Post-Stroke Fatigue

Oyake

Baba

Suda

et al. 2020

Preprint

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Physical deconditioning after stroke may induce post-stroke fatigue. However, research on this association is limited. Our primary objective was to investigate the associations of post-stroke fatigue with oxygen uptake (⩒O2) at peak exercise and the time constant of ⩒O2 kinetics (τ⩒O2) at the onset of exercise. The secondary objective was to examine the associations between fatigue and cardiorespiratory variables potentially affecting ⩒O2 during exercise. Twenty-three inpatients from a subacute rehabilitation ward were enrolled in this study. The median (interquartile range) Fatigue Severity Scale (FSS) score as a measure of fatigue was 32 (27, 42) points. The FSS score was not associated with ⩒O2 at peak exercise during a symptom-limited graded exercise test (rho = −0.264; p = 0.224), while it was significantly associated with τ⩒O2 during a submaximal constant-load exercise test (rho = 0.530; p = 0.009). A higher FSS score was also significantly correlated with a longer time constant of cardiac output kinetics (rho = 0.476, p = 0.022). These results suggest that the ability of the cardiorespiratory system to adapt to exercise is impaired in individuals with severe post-stroke fatigue. Our findings can contribute to the development of an appropriate rehabilitation program for such individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ability of The Cardiorespiratory System to Adapt to Exercise is Impaired in Individuals With Severe Post-Stroke Fatigue

Oyake

Baba

Suda

et al. 2020

Preprint

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“…According to Saunders, 15 there is sufficient evidence to incorporate cardiorespiratory and mixed training within poststroke rehabilitation programs to improve the speed and tolerance of walking. The American Heart Association recommends 20- to 60-minute sessions of aerobic exercise training 3-5 days per week after stroke.…”

Section: Methodsmentioning

confidence: 99%

Effects of In-Bed Cycle Exercise in Patients With Acute Stroke: A Randomized Controlled Trial

Sandberg

Kleist

Wijkman

et al. 2020

Archives of Rehabilitation Research and Clinical Translation

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Objective To investigate the effects of in-bed cycle exercise in addition to usual care in patients with acute stroke, National Institutes of Health Stroke Scale (NIHSS) 7-42, regarding walking ability, functional outcomes, and inpatient care days. Design Randomized controlled trial. Setting Hospital care. Participants Patients (N=56) with stroke NIHSS 7-42 were recruited 24-48 hours after stroke onset from 2 stroke units in Sweden. Interventions Both groups received usual care. The intervention group also received 20 minutes bed cycling 5 days per week with a maximum of 15 sessions. Main Outcome Measures The primary outcome was median change in walking ability measured with the 6-minute walk test (6MWT). Secondary outcome measures included the median change in modified Rankin Scale (mRS), Barthel Index (BI) for activities of daily living, and inpatient care days. Measurements were performed at baseline, post intervention (3 weeks), and at 3-month follow-up. Results There was no significant difference in change of walking ability (6MWT) from baseline to follow-up between the intervention and control groups (median, 105m [interquartile range [IQR, 220m] vs 30m [IQR, 118m], respectively, P =.147, d =0.401). There were no significant differences between groups regarding mRS, BI, or inpatient care days. Patients with less serious stroke (NIHSS 7-12) seemed to benefit from the intervention. Conclusion Although this study may have been underpowered, patients with stroke NIHSS 7-42 did not benefit from in-bed cycle exercise in addition to usual care after acute stroke. A larger study is needed to confirm our results.

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“…Training individuals that have instability and sensory avoidance to produce effective postural behaviors have obvious value and there are some studies demonstrating carryover to the functional postural behavior of individuals with labyrinthine loss ( Haran and Keshner, 2008 ; Bao et al, 2019 ), Parkinson’s disease ( Bryant et al, 2016 ; Nero et al, 2019 ; Rennie et al, 2020 ), and stroke ( Van Nes et al, 2006 ; Madhavan et al, 2019 ; Saunders et al, 2020 ). The very strong directional effect of optic flow on posture and spatial orientation ( Keshner and Kenyon, 2000 ) would support incorporating this technology into any balance rehabilitation program.…”

Section: Manipulating Visual Motion Information (Optic Flow)mentioning

confidence: 99%

The Untapped Potential of Virtual Reality in Rehabilitation of Balance and Gait in Neurological Disorders

Keshner

Lamontagne

2021

Front. Virtual Real.

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Dynamic systems theory transformed our understanding of motor control by recognizing the continual interaction between the organism and the environment. Movement could no longer be visualized simply as a response to a pattern of stimuli or as a demonstration of prior intent; movement is context dependent and is continuously reshaped by the ongoing dynamics of the world around us. Virtual reality is one methodological variable that allows us to control and manipulate that environmental context. A large body of literature exists to support the impact of visual flow, visual conditions, and visual perception on the planning and execution of movement. In rehabilitative practice, however, this technology has been employed mostly as a tool for motivation and enjoyment of physical exercise. The opportunity to modulate motor behavior through the parameters of the virtual world is often ignored in practice. In this article we present the results of experiments from our laboratories and from others demonstrating that presenting particular characteristics of the virtual world through different sensory modalities will modify balance and locomotor behavior. We will discuss how movement in the virtual world opens a window into the motor planning processes and informs us about the relative weighting of visual and somatosensory signals. Finally, we discuss how these findings should influence future treatment design.

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Physical fitness training for stroke patients

Cited by 138 publications

References 357 publications

Ability of The Cardiorespiratory System to Adapt to Exercise is Impaired in Individuals With Severe Post-Stroke Fatigue

Ability of The Cardiorespiratory System to Adapt to Exercise is Impaired in Individuals With Severe Post-Stroke Fatigue

Effects of In-Bed Cycle Exercise in Patients With Acute Stroke: A Randomized Controlled Trial

The Untapped Potential of Virtual Reality in Rehabilitation of Balance and Gait in Neurological Disorders

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