title: Exercise Induces Peripheral Muscle But Not Cardiac Adaptations After Stroke: A Randomized Controlled Pilot Trial.
abstract: OBJECTIVE
  To explore the physiological factors affecting exercise-induced changes in peak oxygen consumption and function poststroke.
  
  
  METHODS
  Single-center, single-blind, randomized controlled pilot trial.
  
  
  METHODS
  Community stroke services.
  
  
  METHODS
  Adults (N=40; age>50y; independent with/without stick) with stroke (diagnosed >6 mo previously) were recruited from 117 eligible participants. Twenty participants were randomized to the intervention group and 20 to the control group. No dropouts or adverse events were reported.
  
  
  METHODS
  Intervention group: 19-week (3 times/wk) progressive mixed (aerobic/strength/balance/flexibility) community group exercise program. Control group: Matched duration home stretching program.
  
  
  METHODS
  (1) Pre- and postintervention: maximal cardiopulmonary exercise testing with noninvasive (bioreactance) cardiac output measurements; and (2) functional outcome measures: 6-minute walk test; timed Up and Go test, and Berg Balance Scale.
  
  
  RESULTS
  Exercise improved peak oxygen consumption (18±5 to 21±5 mL/(kg⋅min); P<.01) and peak arterial-venous oxygen difference (9.2±2.7 to 11.4±2.9 mL of O2/100 mL of blood; P<.01), but did not alter cardiac output (17.2±4 to 17.7±4.2 L/min; P=.44) or cardiac power output (4.8±1.3 to 5.0±1.35 W; P=.45). A significant relation existed between change in peak oxygen consumption and change in peak arterial-venous oxygen difference (r=.507; P<.05), but not with cardiac output. Change in peak oxygen consumption did not strongly correlate with change in function.
  
  
  CONCLUSIONS
  Exercise induced peripheral muscle, but not cardiac output, adaptations after stroke. Implications for stroke clinical care should be explored further in a broader cohort.
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom. Electronic address: s.a.moore@ncl.ac.uk.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Moore
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Research Councils UK, Newcastle Centre for Ageing and Vitality, Newcastle upon Tyne, United Kingdom.
authors.forename: Djordje G
authors.initials: DG
authors.lastname: Jakovljevic
authors.affiliation: University of Oxford, Oxford, United Kingdom.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Ford
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Research Councils UK, Newcastle Centre for Ageing and Vitality, Newcastle upon Tyne, United Kingdom.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Trenell
mesh_terms: D000368:Aged; D002302:Cardiac Output / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010101:Oxygen Consumption; D010865:Pilot Projects; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation
keywords: Cardiac output; Exercise; Physical fitness; Rehabilitation; Stroke