Cargando…
Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial
BACKGROUND: Stroke is a leading cause of disability worldwide and the cardiovascular fitness levels of stroke survivors are diminished to an extent that impairs functioning and activities of daily living performance. While cardiovascular training seems an empirically appropriate intervention, the op...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983371/ https://www.ncbi.nlm.nih.gov/pubmed/33745454 http://dx.doi.org/10.1186/s12883-021-02052-8 |
_version_ | 1783667891865911296 |
---|---|
author | Reynolds, Hanna Steinfort, Sarah Tillyard, Jane Ellis, Sarah Hayes, Alan Hanson, Erik D. Wijeratne, Tissa Skinner, Elizabeth H. |
author_facet | Reynolds, Hanna Steinfort, Sarah Tillyard, Jane Ellis, Sarah Hayes, Alan Hanson, Erik D. Wijeratne, Tissa Skinner, Elizabeth H. |
author_sort | Reynolds, Hanna |
collection | PubMed |
description | BACKGROUND: Stroke is a leading cause of disability worldwide and the cardiovascular fitness levels of stroke survivors are diminished to an extent that impairs functioning and activities of daily living performance. While cardiovascular training seems an empirically appropriate intervention, the optimal dosage and intensity of cardiovascular training in stroke survivors remains unclear. The aim was to determine the safety and feasibility of moderate-intensity cardiovascular training following stroke, including measurement of adherence to training. METHODS: A pilot, prospective, patient- and assessor-blinded randomised controlled trial conducted in a tertiary, metropolitan hospital-based community rehabilitation centre. Eligibility criteria included ambulant (> 100 m), 6 weeks-12 months post stroke. Moderate-intensity fitness training or control (low-intensity) exercise was offered biweekly for 12 weeks. Outcome measures included adverse events, peak oxygen uptake (VO(2)), functional exercise capacity (6-Minute Walk Test, 10-m Walk Test) and health-related quality of life (Short Form-36) and mood (Patient Health Questionnaire, PHQ9). RESULTS: Feasibility: Seventy-one (50%) of 141 screened participants were eligible (29% did not agree to participate). Twenty participants (10 intervention, 10 control) were recruited. The median (%; IQR) supervised sessions was 19.5 (81%; 12, 20); and 20 (83%; 19, 22) in the intervention and control groups, respectively. Progression of duration and intensity was limited; mean of 10 sessions to achieve target duration (30 min). There were no adverse events. Baseline peak oxygen uptake (VO(2)) levels were low (15.94 ml/kg/min). Significant improvements in VO(2) peak in both groups were observed (p < 0.05). Although there were no significant between-group differences, this feasibility trial was not powered to detect change. CONCLUSIONS: Moderate-intensity fitness training was safe but achievement of target duration and intensity was challenging for stroke survivors. A definitive adequately-powered randomised trial is required. Alternative fitness training protocols may need to be explored. TRIAL REGISTRATION: The trial protocol was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN 12613000822785) on 25/07/2013. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-021-02052-8. |
format | Online Article Text |
id | pubmed-7983371 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79833712021-03-22 Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial Reynolds, Hanna Steinfort, Sarah Tillyard, Jane Ellis, Sarah Hayes, Alan Hanson, Erik D. Wijeratne, Tissa Skinner, Elizabeth H. BMC Neurol Research Article BACKGROUND: Stroke is a leading cause of disability worldwide and the cardiovascular fitness levels of stroke survivors are diminished to an extent that impairs functioning and activities of daily living performance. While cardiovascular training seems an empirically appropriate intervention, the optimal dosage and intensity of cardiovascular training in stroke survivors remains unclear. The aim was to determine the safety and feasibility of moderate-intensity cardiovascular training following stroke, including measurement of adherence to training. METHODS: A pilot, prospective, patient- and assessor-blinded randomised controlled trial conducted in a tertiary, metropolitan hospital-based community rehabilitation centre. Eligibility criteria included ambulant (> 100 m), 6 weeks-12 months post stroke. Moderate-intensity fitness training or control (low-intensity) exercise was offered biweekly for 12 weeks. Outcome measures included adverse events, peak oxygen uptake (VO(2)), functional exercise capacity (6-Minute Walk Test, 10-m Walk Test) and health-related quality of life (Short Form-36) and mood (Patient Health Questionnaire, PHQ9). RESULTS: Feasibility: Seventy-one (50%) of 141 screened participants were eligible (29% did not agree to participate). Twenty participants (10 intervention, 10 control) were recruited. The median (%; IQR) supervised sessions was 19.5 (81%; 12, 20); and 20 (83%; 19, 22) in the intervention and control groups, respectively. Progression of duration and intensity was limited; mean of 10 sessions to achieve target duration (30 min). There were no adverse events. Baseline peak oxygen uptake (VO(2)) levels were low (15.94 ml/kg/min). Significant improvements in VO(2) peak in both groups were observed (p < 0.05). Although there were no significant between-group differences, this feasibility trial was not powered to detect change. CONCLUSIONS: Moderate-intensity fitness training was safe but achievement of target duration and intensity was challenging for stroke survivors. A definitive adequately-powered randomised trial is required. Alternative fitness training protocols may need to be explored. TRIAL REGISTRATION: The trial protocol was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN 12613000822785) on 25/07/2013. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-021-02052-8. BioMed Central 2021-03-22 /pmc/articles/PMC7983371/ /pubmed/33745454 http://dx.doi.org/10.1186/s12883-021-02052-8 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Reynolds, Hanna Steinfort, Sarah Tillyard, Jane Ellis, Sarah Hayes, Alan Hanson, Erik D. Wijeratne, Tissa Skinner, Elizabeth H. Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial |
title | Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial |
title_full | Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial |
title_fullStr | Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial |
title_full_unstemmed | Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial |
title_short | Feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial |
title_sort | feasibility and adherence to moderate intensity cardiovascular fitness training following stroke: a pilot randomized controlled trial |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983371/ https://www.ncbi.nlm.nih.gov/pubmed/33745454 http://dx.doi.org/10.1186/s12883-021-02052-8 |
work_keys_str_mv | AT reynoldshanna feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial AT steinfortsarah feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial AT tillyardjane feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial AT ellissarah feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial AT hayesalan feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial AT hansonerikd feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial AT wijeratnetissa feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial AT skinnerelizabethh feasibilityandadherencetomoderateintensitycardiovascularfitnesstrainingfollowingstrokeapilotrandomizedcontrolledtrial |