Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke : A randomized, controlled trial
Physical inactivity propagates disability after stroke through physical deconditioning and learned nonuse. We investigated whether treadmill aerobic training (T-AEX) is more effective than conventional rehabilitation to improve ambulatory function and cardiovascular fitness in patients with chronic...
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| Veröffentlicht in: | Stroke (1970) 2005-10, Vol.36 (10), p.2206-2211 |
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| container_title | Stroke (1970) |
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| creator | MACKO, Richard F IVEY, Frederick M FORRESTER, Larry W HANLEY, Daniel SORKIN, John D KATZEL, Leslie I SILVER, Kenneth H GOLDBERG, Andrew P |
| description | Physical inactivity propagates disability after stroke through physical deconditioning and learned nonuse. We investigated whether treadmill aerobic training (T-AEX) is more effective than conventional rehabilitation to improve ambulatory function and cardiovascular fitness in patients with chronic stroke.
Sixty-one adults with chronic hemiparetic gait after ischemic stroke (>6 months) were randomized to 6 months (3x/week) progressive T-AEX or a reference rehabilitation program of stretching plus low-intensity walking (R-CONTROL). Peak exercise capacity (Vo2 peak), o2 consumption during submaximal effort walking (economy of gait), timed walks, Walking Impairment Questionnaire (WIQ), and Rivermead Mobility Index (RMI) were measured before and after 3 and 6 months of training.
Twenty-five patients completed T-AEX and 20 completed R-CONTROL. Only T-AEX increased cardiovascular fitness (17% versus 3%, delta% T-AEX versus R-CONTROL, P |
| doi_str_mv | 10.1161/01.STR.0000181076.91805.89 |
| format | Article |
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Sixty-one adults with chronic hemiparetic gait after ischemic stroke (>6 months) were randomized to 6 months (3x/week) progressive T-AEX or a reference rehabilitation program of stretching plus low-intensity walking (R-CONTROL). Peak exercise capacity (Vo2 peak), o2 consumption during submaximal effort walking (economy of gait), timed walks, Walking Impairment Questionnaire (WIQ), and Rivermead Mobility Index (RMI) were measured before and after 3 and 6 months of training.
Twenty-five patients completed T-AEX and 20 completed R-CONTROL. Only T-AEX increased cardiovascular fitness (17% versus 3%, delta% T-AEX versus R-CONTROL, P<0.005). Group-by-time analyses revealed T-AEX improved ambulatory performance on 6-minute walks (30% versus 11%, P<0.02) and mobility function indexed by WIQ distance scores (56% versus 12%, P<0.05). In the T-AEX group, increasing training velocity predicted improved Vo2 peak (r=0.43, P<0.05), but not walking function. In contrast, increasing training session duration predicted improved 6-minute walk (r=0.41, P<0.05), but not fitness gains.
T-AEX improves both functional mobility and cardiovascular fitness in patients with chronic stroke and is more effective than reference rehabilitation common to conventional care. Specific characteristics of training may determine the nature of exercise-mediated adaptations.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000181076.91805.89</identifier><identifier>PMID: 16151035</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Analysis of Variance ; Biological and medical sciences ; Brain Ischemia - pathology ; Brain Ischemia - rehabilitation ; Cardiovascular System ; Double-Blind Method ; Exercise ; Exercise Test ; Exercise Therapy ; Exercise Tolerance ; Female ; Gait ; Gait Disorders, Neurologic - rehabilitation ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Hemiplegia - rehabilitation ; Humans ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Neuropharmacology ; Pharmacology. Drug treatments ; Physical Endurance ; Physical Fitness ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Stroke - therapy ; Stroke Rehabilitation ; Surveys and Questionnaires ; Time Factors ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2005-10, Vol.36 (10), p.2206-2211</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-e5e50fc6ec3729fdec7905392832340a4aac3958da7f53a83eea6c4bf8afd5df3</citedby><cites>FETCH-LOGICAL-c447t-e5e50fc6ec3729fdec7905392832340a4aac3958da7f53a83eea6c4bf8afd5df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17204119$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16151035$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MACKO, Richard F</creatorcontrib><creatorcontrib>IVEY, Frederick M</creatorcontrib><creatorcontrib>FORRESTER, Larry W</creatorcontrib><creatorcontrib>HANLEY, Daniel</creatorcontrib><creatorcontrib>SORKIN, John D</creatorcontrib><creatorcontrib>KATZEL, Leslie I</creatorcontrib><creatorcontrib>SILVER, Kenneth H</creatorcontrib><creatorcontrib>GOLDBERG, Andrew P</creatorcontrib><title>Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke : A randomized, controlled trial</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Physical inactivity propagates disability after stroke through physical deconditioning and learned nonuse. We investigated whether treadmill aerobic training (T-AEX) is more effective than conventional rehabilitation to improve ambulatory function and cardiovascular fitness in patients with chronic stroke.
Sixty-one adults with chronic hemiparetic gait after ischemic stroke (>6 months) were randomized to 6 months (3x/week) progressive T-AEX or a reference rehabilitation program of stretching plus low-intensity walking (R-CONTROL). Peak exercise capacity (Vo2 peak), o2 consumption during submaximal effort walking (economy of gait), timed walks, Walking Impairment Questionnaire (WIQ), and Rivermead Mobility Index (RMI) were measured before and after 3 and 6 months of training.
Twenty-five patients completed T-AEX and 20 completed R-CONTROL. Only T-AEX increased cardiovascular fitness (17% versus 3%, delta% T-AEX versus R-CONTROL, P<0.005). Group-by-time analyses revealed T-AEX improved ambulatory performance on 6-minute walks (30% versus 11%, P<0.02) and mobility function indexed by WIQ distance scores (56% versus 12%, P<0.05). In the T-AEX group, increasing training velocity predicted improved Vo2 peak (r=0.43, P<0.05), but not walking function. In contrast, increasing training session duration predicted improved 6-minute walk (r=0.41, P<0.05), but not fitness gains.
T-AEX improves both functional mobility and cardiovascular fitness in patients with chronic stroke and is more effective than reference rehabilitation common to conventional care. Specific characteristics of training may determine the nature of exercise-mediated adaptations.</description><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Brain Ischemia - pathology</subject><subject>Brain Ischemia - rehabilitation</subject><subject>Cardiovascular System</subject><subject>Double-Blind Method</subject><subject>Exercise</subject><subject>Exercise Test</subject><subject>Exercise Therapy</subject><subject>Exercise Tolerance</subject><subject>Female</subject><subject>Gait</subject><subject>Gait Disorders, Neurologic - rehabilitation</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Hemiplegia - rehabilitation</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Physical Endurance</subject><subject>Physical Fitness</subject><subject>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Stroke - therapy</subject><subject>Stroke Rehabilitation</subject><subject>Surveys and Questionnaires</subject><subject>Time Factors</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkVtvFCEYhidGY9fqXzDExHrjjjAcBnrXNJ6SJia6XhMWPrIoM6zAVOtP8ddK2032Trnh4nvel8PTdS8I7gkR5A0m_ZfN5x63RSTBo-gVkZj3Uj3oVoQPbM3EIB92K4ypWg9MqZPuSSnfGj9QyR93J62FE0z5qvuzyWDcFGJE8AuyDQVQhp3ZhhiqqSHNKEz7nK6hIDNtl2hqyjfIL7O9G5rZIWuyC-naFNvGGflQZygFhRntWwPMtaCfoe6Q3eU0B4tKzek7oHN0gXLLpyn8Bvca2TS3QYzgUM3BxKfdI29igWeH_bT7-u7t5vLD-urT-4-XF1dry9hY18CBY28FWDoOyjuwo8KcqkHSgTJsmDGWKi6dGT2nRlIAIyzbemm8487T0-7VfW975o8FStVTKBZiNDOkpehxJEIpLmQjz_5JCimoUJj8FyTj7f04a-D5PWhzKiWD1_scJpNvNMH6VrbGRDfZ-ihb38nWUrXw88Mpy3YCd4we7Dbg5QFobkz07beb4CM3DpgRouhf0bK3hQ</recordid><startdate>20051001</startdate><enddate>20051001</enddate><creator>MACKO, Richard F</creator><creator>IVEY, Frederick M</creator><creator>FORRESTER, Larry W</creator><creator>HANLEY, Daniel</creator><creator>SORKIN, John D</creator><creator>KATZEL, Leslie I</creator><creator>SILVER, Kenneth H</creator><creator>GOLDBERG, Andrew P</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7X8</scope></search><sort><creationdate>20051001</creationdate><title>Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke : A randomized, controlled trial</title><author>MACKO, Richard F ; IVEY, Frederick M ; FORRESTER, Larry W ; HANLEY, Daniel ; SORKIN, John D ; KATZEL, Leslie I ; SILVER, Kenneth H ; GOLDBERG, Andrew P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-e5e50fc6ec3729fdec7905392832340a4aac3958da7f53a83eea6c4bf8afd5df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Brain Ischemia - pathology</topic><topic>Brain Ischemia - rehabilitation</topic><topic>Cardiovascular System</topic><topic>Double-Blind Method</topic><topic>Exercise</topic><topic>Exercise Test</topic><topic>Exercise Therapy</topic><topic>Exercise Tolerance</topic><topic>Female</topic><topic>Gait</topic><topic>Gait Disorders, Neurologic - rehabilitation</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Hemiplegia - rehabilitation</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Physical Endurance</topic><topic>Physical Fitness</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Stroke - therapy</topic><topic>Stroke Rehabilitation</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MACKO, Richard F</creatorcontrib><creatorcontrib>IVEY, Frederick M</creatorcontrib><creatorcontrib>FORRESTER, Larry W</creatorcontrib><creatorcontrib>HANLEY, Daniel</creatorcontrib><creatorcontrib>SORKIN, John D</creatorcontrib><creatorcontrib>KATZEL, Leslie I</creatorcontrib><creatorcontrib>SILVER, Kenneth H</creatorcontrib><creatorcontrib>GOLDBERG, Andrew P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MACKO, Richard F</au><au>IVEY, Frederick M</au><au>FORRESTER, Larry W</au><au>HANLEY, Daniel</au><au>SORKIN, John D</au><au>KATZEL, Leslie I</au><au>SILVER, Kenneth H</au><au>GOLDBERG, Andrew P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke : A randomized, controlled trial</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2005-10-01</date><risdate>2005</risdate><volume>36</volume><issue>10</issue><spage>2206</spage><epage>2211</epage><pages>2206-2211</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Physical inactivity propagates disability after stroke through physical deconditioning and learned nonuse. We investigated whether treadmill aerobic training (T-AEX) is more effective than conventional rehabilitation to improve ambulatory function and cardiovascular fitness in patients with chronic stroke.
Sixty-one adults with chronic hemiparetic gait after ischemic stroke (>6 months) were randomized to 6 months (3x/week) progressive T-AEX or a reference rehabilitation program of stretching plus low-intensity walking (R-CONTROL). Peak exercise capacity (Vo2 peak), o2 consumption during submaximal effort walking (economy of gait), timed walks, Walking Impairment Questionnaire (WIQ), and Rivermead Mobility Index (RMI) were measured before and after 3 and 6 months of training.
Twenty-five patients completed T-AEX and 20 completed R-CONTROL. Only T-AEX increased cardiovascular fitness (17% versus 3%, delta% T-AEX versus R-CONTROL, P<0.005). Group-by-time analyses revealed T-AEX improved ambulatory performance on 6-minute walks (30% versus 11%, P<0.02) and mobility function indexed by WIQ distance scores (56% versus 12%, P<0.05). In the T-AEX group, increasing training velocity predicted improved Vo2 peak (r=0.43, P<0.05), but not walking function. In contrast, increasing training session duration predicted improved 6-minute walk (r=0.41, P<0.05), but not fitness gains.
T-AEX improves both functional mobility and cardiovascular fitness in patients with chronic stroke and is more effective than reference rehabilitation common to conventional care. Specific characteristics of training may determine the nature of exercise-mediated adaptations.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>16151035</pmid><doi>10.1161/01.STR.0000181076.91805.89</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Stroke (1970), 2005-10, Vol.36 (10), p.2206-2211 |
| issn | 0039-2499 1524-4628 |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Aged Analysis of Variance Biological and medical sciences Brain Ischemia - pathology Brain Ischemia - rehabilitation Cardiovascular System Double-Blind Method Exercise Exercise Test Exercise Therapy Exercise Tolerance Female Gait Gait Disorders, Neurologic - rehabilitation Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Hemiplegia - rehabilitation Humans Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Neuropharmacology Pharmacology. Drug treatments Physical Endurance Physical Fitness Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopharmacology Stroke - therapy Stroke Rehabilitation Surveys and Questionnaires Time Factors Vascular diseases and vascular malformations of the nervous system |
| title | Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke : A randomized, controlled trial |
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