4.4 Article

Aerobic Exercise in Subacute Stroke Improves Cardiovascular Health and Physical Performance

期刊

JOURNAL OF NEUROLOGIC PHYSICAL THERAPY
卷 36, 期 4, 页码 159-165

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NPT.0b013e318274d082

关键词

blood flow; cerebrovascular accident; oxygen uptake; physical fitness; vasomotor reactivity

资金

  1. Eunice Kennedy Shriver National Institute of Child Health and Human Development [K01HD067318, T32HD057850]
  2. Frontiers: The Heartland Institute for Clinical and Translational Research (University of Kansas Medical Center's Clinical and Translational Science Award) [UL1RR033179]

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Background and Purpose: Cardiovascular health is often impaired after stroke. Reduced exercise capacity ((V)over dotO(2peak)) and changes in the vascular system in the stroke-affected limb may impact performance of physical activities such as walking. There is little information regarding the role of prescribed moderate- to high-intensity exercise in subacute stroke. The purpose of this study was to examine whether an 8-week aerobic exercise intervention would improve cardiovascular health and physical performance in participants with subacute stroke. Methods: Ten subjects were enrolled in the study and 9 of them completed the intervention. Participants were aged 61.2 +/- 4.7 years old, were 66.7 +/- 41.5 days poststroke, and had minor motor performance deficits (Fugl-Meyer score, 100.3 +/- 29.3). Outcome measures were taken at baseline, postintervention, and at 1-month follow-up. Brachial artery vasomotor reactivity (flow-mediated dilation [FMD]) of both arms was used to assess vascular health, and a peak exercise test was used to assess exercise capacity. The 6-minute walk test (6MWT) was used to assess physical performance. Participants exercised on a recumbent stepper 3 times per week for 8 weeks at a prescribed heart rate intensity. Results: At baseline, we identified between-limb differences in brachial artery FMD and low (V)over dotO(2peak) values. After the intervention, significant improvements were observed in the FMD in both arms, resting systolic blood pressure, and the 6MWT. Although we also observed improvements in the resting diastolic blood pressure, heart rate, and (V)over dotO(2peak) values, these changes were not significantly different. Discussion and Conclusion: Aerobic exercise in participants with subacute stroke was beneficial for improving cardiovascular health, reducing cardiac risk, and improving physical performance (6MWT). Video abstract available (see the Video, Supplemental Digital Content 1, http://links.1ww.com/JNPT/A29) for more insights from the authors.

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