PMID- 26303787
OWN - NLM
STAT- MEDLINE
DCOM- 20160809
LR  - 20181113
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Print)
IS  - 1052-3057 (Linking)
VI  - 24
IP  - 11
DP  - 2015 Nov
TI  - Higher Treadmill Training Intensity to Address Functional Aerobic Impairment 
      after Stroke.
PG  - 2539-46
LID - S1052-3057(15)00388-2 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2015.07.002 [doi]
AB  - BACKGROUND: Peak aerobic capacity (VO2 peak) is severely worsened after disabling 
      stroke, having serious implications for function, metabolism, and ongoing 
      cardiovascular risk. Work from our laboratory and others has previously shown 
      that modest improvements in VO2 peak are possible in stroke participants with 
      aerobic exercise training. The purpose of the current investigation was to test 
      the extent to which greater enhancements in VO2 peak after stroke are possible 
      using a treadmill protocol with far greater emphasis on intensity progression 
      compared with a protocol without such emphasis. METHODS: Using a randomized 
      design, we compared stroke survivors engaged in higher intensity treadmill 
      training (HI-TM, 80% heart rate reserve [HRR]) with those undergoing lower 
      intensity treadmill training (LO-TM, 50% HRR). Measured outcomes were change in 
      VO2 peak, 6-minute walk distance (6MWD), 30-ft walk times (30WT), and 48-hour 
      step counts (48SC). LO-TM participants trained for a longer period of time per 
      session in an effort to approximately match workload/caloric expenditure. 
      Participants were randomized with stratification according to age and baseline 
      walking capacity. RESULTS: HI-TM participants (n = 18) had significantly greater 
      gains in VO2 peak (+34%) than LO-TM participants (n = 16; +5%) across the 6-month 
      intervention period (P = .001, group x time interaction). Conversely, there was 
      no statistical difference between groups in the changes observed for 6MWD, 30WT, 
      or 48SC. CONCLUSIONS: HI-TM is far more effective than LO-TM for improving VO2 
      peak after disabling stroke. The magnitude of relative improvement for HI-TM was 
      double compared with previous reports from our laboratory with probable clinical 
      significance for this population.
CI  - Published by Elsevier Inc.
FAU - Ivey, Frederick M
AU  - Ivey FM
AD  - Department of Veterans Affairs and Veterans Affairs Medical Center, Maryland 
      Exercise and Robotics Center of Excellence (MERCE) & Geriatric Research, 
      Education and Clinical Center (GRECC), Baltimore, Maryland; Department of 
      Neurology, University of Maryland School of Medicine, Baltimore, Maryland. 
      Electronic address: fivey@grecc.umaryland.edu.
FAU - Stookey, Alyssa D
AU  - Stookey AD
AD  - Department of Veterans Affairs and Veterans Affairs Medical Center, Maryland 
      Exercise and Robotics Center of Excellence (MERCE) & Geriatric Research, 
      Education and Clinical Center (GRECC), Baltimore, Maryland.
FAU - Hafer-Macko, Charlene E
AU  - Hafer-Macko CE
AD  - Department of Veterans Affairs and Veterans Affairs Medical Center, Maryland 
      Exercise and Robotics Center of Excellence (MERCE) & Geriatric Research, 
      Education and Clinical Center (GRECC), Baltimore, Maryland; Department of 
      Neurology, University of Maryland School of Medicine, Baltimore, Maryland.
FAU - Ryan, Alice S
AU  - Ryan AS
AD  - Department of Veterans Affairs and Veterans Affairs Medical Center, Maryland 
      Exercise and Robotics Center of Excellence (MERCE) & Geriatric Research, 
      Education and Clinical Center (GRECC), Baltimore, Maryland; Division of 
      Gerontology and Geriatric Medicine, Department of Medicine, University of 
      Maryland School of Medicine, Baltimore, Maryland.
FAU - Macko, Richard F
AU  - Macko RF
AD  - Department of Veterans Affairs and Veterans Affairs Medical Center, Maryland 
      Exercise and Robotics Center of Excellence (MERCE) & Geriatric Research, 
      Education and Clinical Center (GRECC), Baltimore, Maryland; Department of 
      Neurology, University of Maryland School of Medicine, Baltimore, Maryland.
LA  - eng
GR  - K01 AG019242/AG/NIA NIH HHS/United States
GR  - P30 AG028747/AG/NIA NIH HHS/United States
GR  - K01AG19242/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20150821
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
SB  - IM
MH  - Aged
MH  - Exercise/*physiology
MH  - Exercise Therapy/*methods
MH  - Female
MH  - Heart Rate/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Movement Disorders/*etiology/*rehabilitation
MH  - Oxygen Consumption
MH  - Stroke/*complications
MH  - Walking
PMC - PMC4908456
MID - NIHMS791396
OTO - NOTNLM
OT  - Stroke recovery
OT  - exercise training
OT  - oxygen consumption
OT  - stroke rehabilitation
COIS- Disclosure Statement: There are no conflicts of interest to report.
EDAT- 2015/08/26 06:00
MHDA- 2016/08/10 06:00
PMCR- 2016/06/15
CRDT- 2015/08/26 06:00
PHST- 2014/10/14 00:00 [received]
PHST- 2015/06/27 00:00 [revised]
PHST- 2015/07/07 00:00 [accepted]
PHST- 2015/08/26 06:00 [entrez]
PHST- 2015/08/26 06:00 [pubmed]
PHST- 2016/08/10 06:00 [medline]
PHST- 2016/06/15 00:00 [pmc-release]
AID - S1052-3057(15)00388-2 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2015.07.002 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2015 Nov;24(11):2539-46. doi: 
      10.1016/j.jstrokecerebrovasdis.2015.07.002. Epub 2015 Aug 21.