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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Aerobic exercise | Experimental |
| |
| Resistance exercise | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| aerobic exercise | Behavioral | 40 minutes of aerobic exercise, twice per week for six weeks. Sessions comprised of the following: 10-minute warm-up, 40-minute conditioning period as a circuit, and 10-minute cool-down. Aerobic exercises (for example, recumbent cycling, stepping, arm crank) commenced at an intensity of 40-50% heart rate reserve (HRR) and increased incrementally by 10% as tolerated, up to a maximum of 70-80%. All sessions were individually tailored as far as possible to participants' needs, abilities, and preferences. |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiorespiratory Fitness | Cardiorespiratory fitness was measured by means of a cardiopulmonary exercise test (CPET). Participants were allocated to the order of CPET mode: (1) treadmill with body weight support (TBWS) at baseline, followed by cycle ergometer (CE) post-intervention; or (2) CE at baseline, followed by TBWS post-intervention. For the treadmill protocol, participants were suspended by an overhead harness so that they were still weight-bearing but were able to walk using a reciprocal gait pattern with both feet flat on the treadmill. The starting speed was 0.5km/hr and was increased by 0.5 km/hr every one minute, until test termination. For the cycle ergometer protocol, participants pedalled on an upright ergometer at approximately 50 to 60 revolutions per minute, which increased by five watts, every minute, until test termination. | At baseline, and at the end of the intervention at 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive function | Cognition was measured using the Montreal Cognitive Assessment (MoCA). The minimum score is 0 (indicating severe cognitive impairment) and the maximum score is 30 (indicating normal cognitive function). Scores of lower than 26 may indicate varying levels of cognitive impairment. | At baseline, and at the end of the intervention at 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
Contraindications to Exercise 2014, see below:
Absolute contraindications to exercise:
Relative contraindications to exercise:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of East Anglia | Norwich | NR4 7TJ | United Kingdom |
The data that support the findings of this study are available from the lead contact (AW) upon reasonable request. This includes access to the full protocol and anonymised participant-level dataset.
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| ID | Term |
|---|---|
| D015444 | Exercise |
| D055070 | Resistance Training |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| Resistance exercise | Behavioral | 4 x resistance exercises (3 sets of 6 repetitions), twice per week for six weeks. Strengthening exercises (for example, resistance band work) were prescribed at an intensity that corresponded to 11-12 and incrementally increased to a maximum of 14-15, as tolerated, on the Borg Ratings of Perceived Exertion (RPE) 6-20 Scale. All sessions were individually tailored as far as possible to participants' needs, abilities, and preferences. |
|
| Activities of daily living | Activities of daily living (ADL) was measured using the Barthel Index. Each activity (e.g., feeding, bathing, grooming) is scored based on the level of assistance required. The total score ranges from 0 to 100, with higher scores indicating greater independence. | At baseline, and at the end of the intervention at 8 weeks |
| Stroke specific quality of life | Quality of life (QoL) was measured using the Stroke Specific Quality of Life Questionnaire (SSQoL). Each domain (e.g., mood, personality, social roles) consists of items scored from 1 to 5. The total SS-QOL score ranges from 49 to 245, where higher scores suggest a better stroke-related quality of life. | At baseline, and at the end of the intervention at 8 weeks |
| D005081 | Exercise Therapy |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D064797 | Physical Conditioning, Human |