title: Treadmill training improves fitness reserve in chronic stroke patients.
abstract: OBJECTIVE
  To investigate the hypothesis that treadmill training will improve peak fitness, while lowering the energy cost of hemiparetic gait in chronic stroke patients.
  
  
  METHODS
  Noncontrolled exercise intervention study with repeated-measures analysis.
  
  
  METHODS
  Hospital-based senior exercise research center.
  
  
  METHODS
  Twenty-three patients (mean age +/- standard deviation [SD] 67 +/- 8 yr) with chronic hemiparetic gait after remote (>6 mo) ischemic stroke.
  
  
  METHODS
  Three 40-minute sessions of treadmill exercise weekly for 6 months.
  
  
  METHODS
  Peak exercise capacity (VO2peak) and rate of oxygen consumption during submaximal effort treadmill walking (economy of gait) by open circuit spirometry and ambulatory workload capacity before and after 3 and 6 months of training.
  
  
  RESULTS
  Patients who completed 3 months of training (n = 21) increased their VO2peak +/- SD from 15.4 +/- 2.9 mL x kg(-1) x min(-1) to 17.0 +/- 4.4 mL x kg(-1) x min(-1) (p <.02) and lowered their oxygen demands of submaximal effort ambulation from 9.3 +/- 2 mL x kg(-1) x min(-1) to 7.9 +/- 1.5 mL x kg(-1) x min(-1) (p =.002), which enabled them to perform the same constant-load treadmill task using 20% less of their peak exercise capacity (62.3% +/- 17.2% vs 49.9% +/- 19.3%, p <.002). Gains in VO2peak and economy of gait plateaued by 3 months, while peak ambulatory workload capacity progressively increased by 39% (p <.001) over 6 months.
  
  
  CONCLUSIONS
  Treadmill training improves physiologic fitness reserve in chronic stroke patients by increasing VO2peak while lowering the energy cost of hemiparetic gait, and increases peak ambulatory workload capacity. These improvements may enhance functional mobility in chronic stroke patients.
authors.affiliation: Baltimore Veterans Affairs Medical Center, Geriatrics Research, Education, and Clinical Center, and University of Maryland School of Medicine, Division of Gerontology, Baltimore, MD 21201-1595, USA. richard@grec.umaryland.edu
authors.forename: R F
authors.initials: RF
authors.lastname: Macko
authors.forename: G V
authors.initials: GV
authors.lastname: Smith
authors.forename: C L
authors.initials: CL
authors.lastname: Dobrovolny
authors.forename: J D
authors.initials: JD
authors.lastname: Sorkin
authors.forename: A P
authors.initials: AP
authors.lastname: Goldberg
authors.forename: K H
authors.initials: KH
authors.lastname: Silver
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D010101:Oxygen Consumption; D013147:Spirometry; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*