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Predictors of Improved Aerobic Capacity in Individuals With Chronic Stroke Participating in Cycling Interventions

Published:November 25, 2019DOI:https://doi.org/10.1016/j.apmr.2019.10.187

      Highlights

      • Change in peak oxygen consumption per unit time (VO2peak) was highly variable following an 8-week aerobic cycling program.
      • Higher pedaling cadence during cycling was predictive of improvements in VO2peak.
      • Low baseline VO2peak was also predictive of improvements in VO2peak postexercise.
      • Aerobic intensity did not predict change in VO2peak in persons with chronic stroke.

      Abstract

      Objective

      To determine demographic and physiological factors that predict improvement in aerobic capacity among individuals with chronic stroke participating in cycling interventions.

      Design

      Secondary analysis of data from 2 randomized clinical trials.

      Setting

      Research laboratory.

      Participants

      Individuals with chronic stroke (N=44).

      Interventions

      Participants were randomized to one of the following interventions: forced aerobic exercise and upper extremity repetitive task practice (FE+UERTP, n=16), voluntary aerobic exercise and upper extremity repetitive task practice (VE+UERTP, n=15), or a nonaerobic control group (control, n=13). All interventions were time-matched and occurred 3 times per week for 8 weeks.

      Main Outcome Measure

      Aerobic capacity as measured by peak oxygen consumption per unit time (VO2peak) during maximal cardiopulmonary exercise stress testing.

      Results

      Significant improvements in VO2peak were observed from baseline to postintervention in the VE+UERTP group (P<.001). Considerable variability was observed among participants relating to postintervention change in VO2peak. Among aerobic exercise participants, a multivariate regression analysis revealed that cycling cadence, baseline VO2peak, and group allocation were significant predictors of change in VO2peak.

      Conclusions

      High exercise rate (cycling cadence) appears to be an important variable in improving aerobic capacity and should be considered when prescribing aerobic exercise for individuals with chronic stroke. Those with low VO2peak at baseline may benefit the most from aerobic interventions as it relates to cardiorespiratory fitness. Further investigation is warranted to understand the precise role of other exercise and demographic variables in the prescription of aerobic exercise for this population and their effects on secondary stroke prevention and mortality.

      Keywords

      List of abbreviations:

      CPX (cardiopulmonary exercise), FE (forced aerobic exercise), FE+UERTP (forced aerobic exercise and upper extremity repetitive task practice), VE+UERTP (voluntary aerobic exercise and upper extremity repetitive task practice), VE (voluntary aerobic exercise), VO2peak (peak oxygen consumption per unit time)
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