title: Chronic stroke survivors benefit from high-intensity aerobic treadmill exercise: a randomized control trial.
abstract: OBJECTIVE
  Ambulatory subjects after stroke may benefit from gait-oriented cardiovascular fitness training, but trials to date have not primarily assessed older persons.
  
  
  METHODS
  Thirty-eight subjects (age >60 years) with residual hemiparetic gait were enrolled >6 months after stroke. Participants were randomized to receive 3 months (3×/week) progressive graded, high-intensity aerobic treadmill exercise (TAEX) or conventional care physiotherapy. Primary outcome measures were peak exercise capacity (Vo(2peak)) and sustained walking capacity in 6-minute walks (6MW). Secondary measures were gait velocity in 10-m walks, Berg Balance Scale, functional leg strength (5 chair-rise), self-rated mobility (Rivermead Mobility Index), and quality of life (SF-12).
  
  
  RESULTS
  Thirty-six participants completed the study (18 TAEX, 18 controls). TAEX but not conventional care improved Vo(2peak) (difference 6.4 mL/kg/min, P < .001) and 6MW (53 m, P < .001). Likewise, maximum walking speed (0.13 m/s, P = .01), balance (P < .05), and the mental subscore of the SF-12 (P < .01) improved more after TAEX. Gains in Vo(2peak) correlated with the degree at which training intensity could be progressed in the individual participant (P < .01). Better walking was related to progression in treadmill velocity and training duration (P < .001). Vo(2peak) and 6MW performances were still higher 1 year after the end of training when compared with the baseline, although endurance walking (6MW) at 1 year was lower than immediately after training (P < .01).
  
  
  CONCLUSIONS
  This trial demonstrates that TAEX effectively improves cardiovascular fitness and gait in persons with chronic stroke.
authors: Clinic of Neurology, University Hospital of Zürich, Zürich, Switzerland. christoph.globas@usz.ch
authors: Christoph
authors: C
authors: Globas
authors: Clemens
authors: C
authors: Becker
authors: Joachim
authors: J
authors: Cerny
authors: Judith M
authors: JM
authors: Lam
authors: Ulrich
authors: U
authors: Lindemann
authors: Larry W
authors: LW
authors: Forrester
authors: Richard F
authors: RF
authors: Macko
authors: Andreas R
authors: AR
authors: Luft
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000534:rehabilitation*; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D004856:Postural Balance; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking