Post-exercise hypotensive responses following an acute bout of aquatic and overground treadmill walking in people post-stroke: a pilot study

Abstract

Our results indicate people post-stroke can sustain sufficient walking intensities necessary to reduce BP following cardiovascular exercise. Also, these data suggest that ATW can elicit clinically meaningful reductions in DBP and night-time SBP. Thus, it is recommended for clinicians to consider ATW as a non-pharmaceutical means to regulate DBP and promote nighttime dipping of SBP in people post-stroke. However, caution is advised during the immediate hours after exercise, a period of possible BP inflation.

Acute effects of mixed circuit training on hemodynamic and cardiac autonomic control in chronic hemiparetic stroke patients: A randomized controlled crossover trial

“…However, it must be acknowledged that the sample size was small. Even though this is a relatively common issue in studies including post-stroke patients ( Francica et al, 2015 ; Lai et al, 2015 ), caution is necessary for generalizing the present findings, since low statistical power is associated with an inflated type II error rate (i.e., accepting the null hypothesis when the null hypothesis is false). Also, due to the small sample, it was not possible to perform subgroup analyses according to sex, age, and class of anti-hypertensive drug.…”

“…The prolonged PEH occurred even though usual medication schedules were maintained, reinforcing the clinical impact of regular exercise for stroke patients. Lai et al (2015) investigated the effects of single bouts of aquatic and overground treadmill walking on the magnitude and duration of post-exercise ambulatory BP in post-stroke patients. Exercise bouts were performed for 15 min with an intensity corresponding to 70% VO 2 peak, and post-exercise BP was assessed for 9 h. In comparison to a non-exercise control session, reductions in DBP and SBP of 3%-6% were observed after aquatic but not overground treadmill walking.…”

“…However, little is known about this phenomenon in post-stroke individuals. In a pioneering study involving seven post-stroke individuals aged 56 ± 10 years, Lai et al (2015) observed that a single bout of aquatic walking (15 min at 70% VO 2peak ) induced PEH for 9 h compared to a non-exercise control session (CTL). Although a novel finding of this study was that stroke patients may experience PEH, ambulatory blood pressure monitoring (ABPM) was limited to 12 h. Notably, assessment of 24-h and nighttime BP have been considered optimal to estimate cardiovascular risk.…”

“…To the best of our knowledge, only the study of Lai et al (2015) has investigated the acute ambulatory BP responses to exercise in post-stroke patients. Although evidencing that this population may exhibit PEH, the authors did not investigate its underlying mechanisms.…”

Effects of Acute Aquatic High-Intensity Intermittent Exercise on Blood Pressure and Arterial Stiffness in Postmenopausal Women with Different ACE Genotypes

“…Cunha et al (2016) have suggested that older women excited a 45-min moderate-to-high intensity aquatic exercise, then resting for 21 h, showed an average reduction in SBP and diastolic blood pressure (DBP) of approximately five and one mmHg, respectively [ 16 ]. Lai et al (2015) have observed that SBP decreased by 7.3%, and DBP had no change 9 h after a 25-min aquatic walking exercise with 70% peak oxygen uptake (VO 2peak ) [ 17 ]. Rodriguez et al (2011) studied a 45-min aquatic brisk walking with 40% VO 2peak and found that the average SBP during 30-60 min after exercise and the average DBP during 45–60 min after exercise of untrained women decreased by 9.3% and 8.7%, respectively [ 18 ].…”