title: Intensive aerobic cycling training with lower limb weights in Chinese patients with chronic stroke: discordance between improved cardiovascular fitness and walking ability.
abstract: OBJECTIVE
  To evaluate the effect of aerobic cycling training with lower limb weights on cardiovascular fitness (peak VO(2)) and walking ability in chronic stroke survivors, and to investigate the relationship between changes in these parameters.
  
  
  METHODS
  133 Chinese patients with chronic hemiparetic stroke (mean age 58 years) were randomized to either 8-week (5×/week) aerobic cycling training with lower limb weights group (n = 68) or a low-intensity overground walking group (n = 65). Peak VO(2), 6-minute walk distance (6MWD), knee muscle strength, balance and spasticity were measured before and after intervention.
  
  
  RESULTS
  Cycling training increased peak VO(2) (24% vs. 3%, p < 0.001), 6MWD (2.7% vs. 0.5%, p < 0.001), paretic (11% vs. 1.6%, p < 0.001) and nonparetic knee strength (16% vs. 1.0%, p < 0.001). In the cycling group, percent changes in peak VO(2) were positively associated with those in paretic (r = 0.491, p < 0.001) and nonparetic knee strength (r = 0.432, p < 0.001). Increased 6MWD correlated significantly with improved balance, spasticity and paretic knee strength by the stepwise regression analysis (r(2) = 0.342, p = 0.004), but not fitness gains.
  
  
  CONCLUSIONS
  The enhanced cardiovascular fitness after aerobic cycling training in Chinese patients with chronic stroke is not associated with the increased walking ability. Unparallel improvements in these parameters related different determinants may have implications for intervention strategy.
authors.affiliation: Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China. jinhong5985@163.com
authors.forename: Hong
authors.initials: H
authors.lastname: Jin
authors.forename: Yibo
authors.initials: Y
authors.lastname: Jiang
authors.forename: Qin
authors.initials: Q
authors.lastname: Wei
authors.forename: Bilei
authors.initials: B
authors.lastname: Wang
authors.forename: Genshan
authors.initials: G
authors.lastname: Ma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001642:Bicycling; D002319:Cardiovascular System; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010101:Oxygen Consumption; D010809:Physical Fitness / Q000502:physiology*; D011446:Prospective Studies; D016037:Single-Blind Method; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation; D016138:Walking