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| ID | Type | Description | Link |
|---|---|---|---|
| OSN1207-000144 | Other Grant/Funding Number | OSN1207-000144 |
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| Name | Class |
|---|---|
| Heart and Stroke Foundation of Canada | OTHER |
| Ontario Stroke Network | OTHER |
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Both aerobic training (AT) and resistance/strength training (RT) have the potential to improve recovery after stroke. Research conducted in chronic disease and healthy populations suggest that AT and RT "combination therapy" may produce synergistic and superior effects along cognition and mobility domains, when compared to AT alone. However, the effects of a combined training approach (AT+RT) compared to AT alone has not been investigated in people post-stroke.
Patients referred to Toronto Rehabilitation Institute's Risk Factor Modification and Exercise Program following Stroke (TRI-REPS) will be randomized to either AT+RT or AT alone. Mobility (6 minute walk test), and cognition (Vascular Cognitive Impairment Harmonization Standards) will be measured pre- post 6 months of exercise. Secondary measures will include body composition, and biochemical changes. This project will help to determine an exercise treatment strategy that will guide best practice guidelines aimed at promoting mobility and brain health in people post-stroke.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Aerobic Training | Active Comparator | Walking, elliptical, stationary recumbent or upright cycling will be the modes of AT prescribed depending on individual ability and access to equipment when away from the Centre. Treadmill or overground walking will be considered for those who can sustain high enough speeds and durations to achieve aerobic benefit. Cycle ergometer exercise (upright or recumbent) will be prescribed to patients in addition to walking when stroke-related deficits preclude a sufficient walking speed. The AT group will complete AT 5 d∙wk-1. |
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| Combined Resistance and Aerobic Training | Experimental | The AT+RT group will complete AT 3 d∙wk-1 + RT 2 d∙wk-1.The RT exercises will be task specific, incorporating muscle actions that are performed during daily activities. Resistance will be provided by hand-held dumbbells, exercise bands (wrist/ankle attachments), or patients' body weight. A weight load equivalent to 50-60% of 1 repetition maximum will be prescribed on the non-affected limb. On the hemiparetic limb ≥50% of 1 repetition maximum and/or a resistance rated as 13-14 on the Rating of Perceived Exertion scale on the last repetition of the set will be prescribed |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| combined resistance and aerobic training | Other | For the group randomized to AT+RT, Patients will gradually be progressed from 1-2 sets and then from 10-15 repetitions and then increase resistance by 1.6-5 kg or increase the exercise band level and then reduced repetitions to 10 and repeated this process. |
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive function | Vascular Cognitive Impairment Harmonization Standards | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Body Composition | Fat free mass will be measured by dual energy x-ray absorptiometry | 1 year |
| Biochemical Changes (blood samples) | brain-derived neurotrophic factor, insulin-like growth factor I, homocysteine, and C-reactive protein |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Toronto Rehabilitation Institute | Toronto | Ontario | M5R 1G7 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36417356 | Derived | Vanzella LM, Lawand R, Shuaib M, Oh P, Corbett D, Marzolini S. Validity of Bioelectric Impedance in Relation to Dual-Energy X-Ray Absorptiometry for Measuring Baseline and Change in Body Composition After an Exercise Program in Stroke. J Strength Cond Res. 2022 Dec 1;36(12):3273-3279. doi: 10.1519/JSC.0000000000004287. Epub 2022 Jun 1. |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| 1 year |
| Functional Mobility | Six minute walk distance | 1 year |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |