title: Effectiveness of Active Cycling in Subacute Stroke Rehabilitation: A Randomized Controlled Trial.
abstract: To examine the effects of 3 months of aerobic training (AT) followed by coaching on aerobic capacity, strength, and gait speed after subacute stroke.
  
  
  
  Randomized controlled trial.
  
  
  
  Inpatient rehabilitation center.
  
  
  
  Patients (N=59; mean age ± SD, 65.4±10.3y; 21 women (36%); Barthel Index ≤50 in 64% of patients) with first stroke and able to cycle at 50 revolutions/min were enrolled in the study 3 to 10 weeks after stroke onset.
  
  
  
  Patients were randomly allocated to a 3-month active cycling group (ACG, n=33) and education, or to a control group (CG, n=26). Afterward, patients in the ACG were randomly assigned either to a coaching (n=15) or to a noncoaching group (n=16) for 9 months.
  
  
  
  Aerobic capacity, isometric knee extension strength, and gait ability and speed were measured before and after intervention and during follow-up at 6 and 12 months.
  
  
  
  A nonsignificant difference was found in workload (Wattpeak) (P=.078) between ACG and CG after 3 months. Furthermore, after 3 months of cycling and after 9 months of coaching, all groups showed significant changes over time (P≤.027) in peak oxygen consumption, Wattpeak, leg strength, and gait speed. Also, significant changes over time (P<.001) were found in the ACG and the CG in patients with walking inability at baseline.
  
  
  
  No significant differences between training groups were found over time. Although our study did not have objective exercise data from the training device during follow-up, the 3-month active cycling (AC) program combined with education sessions seemed an applicable method in subacute stroke rehabilitation. New long-term AT interventions should focus on coaching approaches to facilitate training after a supervised AC program.
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp (Faculty of Medicine and Health Sciences), Wilrijk, Belgium; Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium. Electronic address: christel.vanroy@uantwerpen.be.
authors.forename: Christel
authors.initials: C
authors.lastname: Vanroy
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.affiliation: Jessa Hospital, Rehabilitation Campus Sint-Ursula, Herk-de-Stad, Belgium.
authors.forename: Anke
authors.initials: A
authors.lastname: Swinnen
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Vanlandewijck
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp (Faculty of Medicine and Health Sciences), Wilrijk, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Truijen
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp (Faculty of Medicine and Health Sciences), Wilrijk, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vissers
authors.affiliation: Jessa Hospital, Rehabilitation Campus Sint-Ursula, Herk-de-Stad, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Michielsen
authors.affiliation: Department of Scientific Coordination and Biostatistics, University Hospital Antwerp, Edegem, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Wouters
authors.affiliation: Department of Neurology, Translational Neurosciences, University of Antwerp (Faculty of Medicine and Health Sciences), Wilrijk, Belgium; Born-Bunge Institute, Edegem, Belgium; Department of Neurology, University Hospital Antwerp, Edegem, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Cras
mesh_terms: D000368:Aged; D001642:Bicycling / Q000502:physiology*; D000072599:Cardiorespiratory Fitness / Q000502:physiology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007717:Knee / Q000502:physiology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D010353:Patient Education as Topic / Q000458:organization & administration; D012047:Rehabilitation Centers; D000071939:Stroke Rehabilitation / Q000379:methods*
keywords: Cerebrovascular disorders; Clinical trial; Education; Exercise; Mentoring; Rehabilitation