Stroke
Conditions
Keywords
stroke, exercise capacity
Brief summary
Poor cardiopulmonary endurance is observed in individuals with acute stroke, even in chronic. In addition, the poor fitness may obstacle activities of daily life, decrease activities of autonomic system, and increase risks of recurrent, therefore, the cardiopulmonary endurance training should be included into the early-stage rehabilitation program. The ergocycling training could improve cardiopulmonary endurance for individuals with stroke. Moreover, the low-intensity exercise training can increase the willingness, and it is safer than the moderate-intensity exercise training. However, it needs to be evaluated whether the low-intensity exercise training can bring sufficient benefits, compared to the moderate-intensity exercise training. Objectives of the study is to compare the exercise benefits between the low-intensity and moderate-intensity exercise training, and then these would offer optimal exercise prescription and considerations in clinical practice.
Detailed description
After giving their signed consent, subjects would be randomly assigned into the control group (traditional rehabilitation), the low-intensity exercise group (traditional rehabilitation plus low-intensity exercise training), or the moderate-intensity exercise group (traditional rehabilitation plus the moderate-intensity exercise training). Frequency of the exercise training is 2-6 times/week, totally 20 times. In the symptom-limit exercise tolerance tests, subjects wear a gas-collecting mask and electrocardiogram, and pre-set graduated loading was offered by the bike. One therapists and one doctor would monitor the test. For resistance and time setting within each exercise training, it is customized by results of exercise tolerance tests in baseline and the allocation. Moreover, a therapist would stay with subject ,monitor the training, and measure the blood pressure before and after the training.
Interventions
OTHERthe low-intensity exercise group
Totally 20-time training, frequency 2-6 time/week, total 20 times.
OTHERthe moderate-intensity exercise group
Totally 20-time training, frequency 2-6 time/week,total 20 times.
Sponsors
Kaohsiung Medical University Chung-Ho Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. the first-ever stroke 2. period of ischemic stroke onset is longer than two weeks, and less than six months, and the doctors agree with exercise training 3. unilateral hemiplegia 4. no obvious deficits of cognition. Scores of three items in the National Institutes of Health Stroke Scale are zero 5. be willing to join this study and give their consent
Exclusion criteria
1. aphasia 2. orthopedic problems (severe arthritis), neurologic injury (eg. peripheral nerve injury) that can interfere with movement of the lower limb, or cannot sit independently 3. with pace maker, severe cardiac arrhythmia, or heart failure 4. abnormal electrocardiography in rest, is not suitable for exercise tolerance test according to the American College of Sports Medicine guidance, for example, the atrioventricular block (AV block).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| changed value of symptom-limit exercise tolerance tests | Baseline, 4 weeks to 10 weeks for exercise completion, one-month follow-up | One doctor and one therapist monitor the test. EKG and self-report are used. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 10-meter walking test | Baseline, 4 weeks to 10 weeks for exercise completion, one-month follow-up | Time of performing the 10 meters is measured. |
| changed score of the Barthel index | Baseline, 4 weeks to 10 weeks for exercise completion, one-month follow-up | Using Barthel index questionnaire |
| changed score of the Stroke-Specific Quality of Life Scale (SSQOL) | Baseline, 4 weeks to 10 weeks for exercise completion, one-month follow-up | Using SSQOL questionnaire |
| changed activity of autonomic nervous system (ANS) | Baseline, 4 weeks to 10 weeks for exercise completion, one-month follow-up | The frequency domain analysis (measure unit of activity of ANS) is used in two conditions (sit and calculate math; 5 minutes/each condition). |
| changed score of Multi-dimensional Fatigue Inventory | Baseline, 4 weeks to 10 weeks for exercise completion, one-month follow-up | Using Multi-dimensional Fatigue Inventory questionnaire |
| performance of cycling | 4 weeks to 10 weeks for exercise completion | the maximal power is recorded by a chip of the training bike continually during each training;2-6 times/week, total 20 times training. |
| changed value of the Fugl-Meyer Assessment Lower Extremity (FMA-LE) | Baseline, 4 weeks to 10 weeks for exercise completion, one-month follow-up | Measure items of FMA-LE |
Contacts
Primary ContactMiao-Ju Hsu, PHD
Outcome results
None listed