Exercise and Cognition Among Stroke Survivors

Exercise and Cognition Among Stroke Survivors

This study aimed to: (1) identify a suitable cardiopulmonary exercise testing protocol for people with moderate to severe movement impairments after stroke by investigating the safety and feasibility of delivering two methods of CPET modes: treadmill with body-weight support (TBWS) and cycle ergometry (CE); and (2) explore the safety and feasibility of a delivering a 6-week exercise-based intervention or people with moderate to severe movement impairments after stroke, with a view to improve cognitive health.

Inclusion Criteria:

• Have provided informed consent,
• Are aged >18 years,
• Are more than 6 months post-stroke,
• Score 2-3 on the Functional Ambulation Category
• Can follow 1-stage commands i.e. sufficient communication/orientation for interventions in the trial.

Exclusion Criteria:

• Attending any other community exercise class/gym/walking group/rehabilitation class,
• A previous diagnosis of dementia or any other significant cognitive decline,
• Any musculoskeletal or neurophysiological disorder preventing participation in exercise,
• Have uncontrolled hypertension, atrial fibrillation, heart failure or diabetes.
• Weigh over 250lbs/113kg (due to weight restrictions on body-weight support harness on treadmill),
• Meeting any absolute or relative contraindication to exercise from American College of Sports Medicine (ACSM)

Contraindications to Exercise 2014, see below:

Absolute contraindications to exercise:

• A recent significant change in the resting ECG suggesting significant ischaemia, recent myocardial infarction (within 2 days) or other acute cardiac event
• Unstable angina
• Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise
• Symptomatic severe aortic stenosis
• Uncontrolled symptomatic heart failure
• Actuate pulmonary embolus or pulmonary infarction
• Acute myocarditis or pericarditis
• Suspected or know dissecting aneurysm
• Acute systematic infection, accompanied by fever, body aches or swollen lymph glands

Relative contraindications to exercise:

• Left main coronary stenosis
• Moderate stenotic valvular heart disease
• Electrolyte abnormalities e.g. hypokalaemia, hypo-magnesia
• Severe arterial hypertensions i.e. systolic BP of >200mmHg and/or diastolic BP of >110mmHg at rest
• Tachydysrthythmia or bradydsrhythmia
• Hypertrophic cardiomyopathy and other forms of outflow tract obstruction
• Neuromuscular, musculoskeletal or rheumatoid disorders that are exacerbated by exercise
• High-degree atrioventricular block
• Ventricular aneurysm
• Uncontrolled metabolic disease e.g. diabetes, thyrotoxosis or myxedemia Chronic infectious diseases e.g. mononucleosis, hepatitis, AIDs
• Mental or physical impairment leading to inability to exercise adequately