Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors
Objective: To determine whether stroke survivors could maintain workloads during functional task practice that can reach moderate levels of cardiometabolic stress (i.e., ≥40% oxygen uptake reserve (V˙O2R) for ≥20 min) without the use of ergometer-based exercise.Design: Cross-sectional study using co...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-10-01
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| Series: | Frontiers in Physiology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fphys.2017.00809/full |
| _version_ | 1818589230563065856 |
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| author | Liam P. Kelly Augustine J. Devasahayam Arthur R. Chaves Elizabeth M. Wallack Jason McCarthy Fabien A. Basset Michelle Ploughman |
| author_facet | Liam P. Kelly Augustine J. Devasahayam Arthur R. Chaves Elizabeth M. Wallack Jason McCarthy Fabien A. Basset Michelle Ploughman |
| author_sort | Liam P. Kelly |
| collection | DOAJ |
| description | Objective: To determine whether stroke survivors could maintain workloads during functional task practice that can reach moderate levels of cardiometabolic stress (i.e., ≥40% oxygen uptake reserve (V˙O2R) for ≥20 min) without the use of ergometer-based exercise.Design: Cross-sectional study using convenience sampling.Setting: Research laboratory in a tertiary rehabilitation hospital.Participants: Chronic hemiparetic stroke survivors (>6-months) who could provide consent and walk with or without assistance.Intervention: A single bout of intermittent functional training (IFT). The IFT protocol lasted 30 min and involved performing impairment specific multi-joint task-oriented movements structured into circuits lasting ~3 min and allowing 30–45 s recovery between circuits. The aim was to achieve an average heart rate (HR) 30-50 beats above resting without using traditional ergometer-based aerobic exercise.Outcome measures: Attainment of indicators for moderate intensity aerobic exercise. Oxygen uptake (V˙O2), carbon dioxide production (V˙CO2), and HR were recorded throughout the 30 min IFT protocol. Values were reported as percentage of V˙O2R, HR reserve (HRR) and HRR calculated from predicted maximum HR (HRRpred), which were determined from a prior maximal graded exercise test.Results: Ten (3-female) chronic (38 ± 33 months) stroke survivors (70% ischemic) with significant residual impairments (NIHSS: 3 ± 2) and a high prevalence of comorbid conditions (80% ≥ 1) participated. IFT significantly increased all measures of exercise intensity compared to resting levels: V˙O2 (Δ 820 ± 290 ml min−1, p < 0.001), HR (Δ 42 ± 14 bpm, p < 0.001), and energy expenditure (EE; Δ 4.0 ± 1.4 kcal min−1, p < 0.001). Also, mean values for percentage of V˙O2R (62 ± 19), HRR (55 ± 14), and HRRpred (52 ± 18) were significantly higher than the minimum threshold (40%) indicating achievement of moderate intensity aerobic exercise (p = 0.004, 0.016, and 0.043, respectively).Conclusion: Sufficient workloads to achieve moderate levels of cardiometabolic stress can be maintained in chronic stroke survivors using impairment-focused functional movements that are not dependent on ergometers or other specialized equipment. |
| first_indexed | 2024-12-16T09:37:21Z |
| format | Article |
| id | doaj.art-d46cb76c2eb442d3be4d20d447cd26c5 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
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| last_indexed | 2024-12-16T09:37:21Z |
| publishDate | 2017-10-01 |
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| series | Frontiers in Physiology |
| spelling | doaj.art-d46cb76c2eb442d3be4d20d447cd26c52022-12-21T22:36:22ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2017-10-01810.3389/fphys.2017.00809298187Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke SurvivorsLiam P. Kelly0Augustine J. Devasahayam1Arthur R. Chaves2Elizabeth M. Wallack3Jason McCarthy4Fabien A. Basset5Michelle Ploughman6Recovery and Performance Lab, Faculty of Medicine, L.A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, CanadaRecovery and Performance Lab, Faculty of Medicine, L.A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, CanadaRecovery and Performance Lab, Faculty of Medicine, L.A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, CanadaRecovery and Performance Lab, Faculty of Medicine, L.A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, CanadaRecovery and Performance Lab, Faculty of Medicine, L.A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, CanadaSchool of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, CanadaRecovery and Performance Lab, Faculty of Medicine, L.A. Miller Centre, Memorial University of Newfoundland, St. John's, NL, CanadaObjective: To determine whether stroke survivors could maintain workloads during functional task practice that can reach moderate levels of cardiometabolic stress (i.e., ≥40% oxygen uptake reserve (V˙O2R) for ≥20 min) without the use of ergometer-based exercise.Design: Cross-sectional study using convenience sampling.Setting: Research laboratory in a tertiary rehabilitation hospital.Participants: Chronic hemiparetic stroke survivors (>6-months) who could provide consent and walk with or without assistance.Intervention: A single bout of intermittent functional training (IFT). The IFT protocol lasted 30 min and involved performing impairment specific multi-joint task-oriented movements structured into circuits lasting ~3 min and allowing 30–45 s recovery between circuits. The aim was to achieve an average heart rate (HR) 30-50 beats above resting without using traditional ergometer-based aerobic exercise.Outcome measures: Attainment of indicators for moderate intensity aerobic exercise. Oxygen uptake (V˙O2), carbon dioxide production (V˙CO2), and HR were recorded throughout the 30 min IFT protocol. Values were reported as percentage of V˙O2R, HR reserve (HRR) and HRR calculated from predicted maximum HR (HRRpred), which were determined from a prior maximal graded exercise test.Results: Ten (3-female) chronic (38 ± 33 months) stroke survivors (70% ischemic) with significant residual impairments (NIHSS: 3 ± 2) and a high prevalence of comorbid conditions (80% ≥ 1) participated. IFT significantly increased all measures of exercise intensity compared to resting levels: V˙O2 (Δ 820 ± 290 ml min−1, p < 0.001), HR (Δ 42 ± 14 bpm, p < 0.001), and energy expenditure (EE; Δ 4.0 ± 1.4 kcal min−1, p < 0.001). Also, mean values for percentage of V˙O2R (62 ± 19), HRR (55 ± 14), and HRRpred (52 ± 18) were significantly higher than the minimum threshold (40%) indicating achievement of moderate intensity aerobic exercise (p = 0.004, 0.016, and 0.043, respectively).Conclusion: Sufficient workloads to achieve moderate levels of cardiometabolic stress can be maintained in chronic stroke survivors using impairment-focused functional movements that are not dependent on ergometers or other specialized equipment.http://journal.frontiersin.org/article/10.3389/fphys.2017.00809/fullstroke rehabilitationphysical exertionphysical therapy modalitiesaerobic exercisecardiometabolic stress |
| spellingShingle | Liam P. Kelly Augustine J. Devasahayam Arthur R. Chaves Elizabeth M. Wallack Jason McCarthy Fabien A. Basset Michelle Ploughman Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors Frontiers in Physiology stroke rehabilitation physical exertion physical therapy modalities aerobic exercise cardiometabolic stress |
| title | Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors |
| title_full | Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors |
| title_fullStr | Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors |
| title_full_unstemmed | Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors |
| title_short | Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors |
| title_sort | intensifying functional task practice to meet aerobic training guidelines in stroke survivors |
| topic | stroke rehabilitation physical exertion physical therapy modalities aerobic exercise cardiometabolic stress |
| url | http://journal.frontiersin.org/article/10.3389/fphys.2017.00809/full |
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