Exercise Induces Peripheral Muscle But Not Cardiac Adaptations After Stroke: A Randomized Controlled Pilot Trial

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• 作者：Sarah A. Moore ; PhD^a ; ^&lowast ; ; ^{s.a.moore@ncl.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; Djordje G. Jakovljevic ; PhD^a ; ^b ; ^&lowast ; ; Gary A. Ford ; FRCP^c ; Lynn Rochester ; PhD^d ; Michael I. Trenell ; PhD^a ; ^b
• 关键词：Cardiac output ; Exercise ; Physical fitness ; Rehabilitation ; Stroke
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：97
• 期：4
• 页码：596-603
• 全文大小：427 K

文摘

To explore the physiological factors affecting exercise-induced changes in peak oxygen consumption and function poststroke.

Design

Single-center, single-blind, randomized controlled pilot trial.

Setting

Community stroke services.

Participants

Adults (N=40; age>50y; independent with/without stick) with stroke (diagnosed >6mo previously) were recruited from 117 eligible participants. Twenty participants were randomized to the intervention group and 20 to the control group. No dropouts or adverse events were reported.

Interventions

Intervention group: 19-week (3times/wk) progressive mixed (aerobic/strength/balance/flexibility) community group exercise program. Control group: Matched duration home stretching program.

Main Outcome Measures

(1) Pre- and postintervention: maximal cardiopulmonary exercise testing with noninvasive (bioreactance) cardiac output measurements; and (2) functional outcome measures: 6-minute walk test; timed Up and Go test, and Berg Balance Scale.

Results

Exercise improved peak oxygen consumption (18±5 to 21±5mL/(kg⋅min); P<.01) and peak arterial-venous oxygen difference (9.2±2.7 to 11.4±2.9mL of O₂/100mL of blood; P<.01), but did not alter cardiac output (17.2±4 to 17.7±4.2L/min; P=.44) or cardiac power output (4.8±1.3 to 5.0±1.35W; P=.45). A significant relation existed between change in peak oxygen consumption and change in peak arterial-venous oxygen difference (r=.507; P<.05), but not with cardiac output. Change in peak oxygen consumption did not strongly correlate with change in function.

Conclusions

Exercise induced peripheral muscle, but not cardiac output, adaptations after stroke. Implications for stroke clinical care should be explored further in a broader cohort.