The feasibility of moderate-intensity cardiovascular fitness training to improve peak oxygen uptake, function, mood and quality of life following stroke. A pilot randomised controlled trial

Ms Hanna Reynolds1, Ms Sarah Steinfort1, A/Prof Alan Hayes2,3,4, Ms  Sarah  Ellis1, Ms Jane Tillyard1, A/Prof Tissa Wijeratne1, Dr Elizabeth Skinner1,2,3,5,6

1Western Health, Melbourne, Australia, 2Australian Institute of Musculoskeletal Science, Melbourne, Australia, 3Western Centre for Health Research and Education, Melbourne, Australia, 4Victoria University, Melbourne, Australia, 5University of Melbourne, Melbourne, Australia, 6Monash University, Melbourne, Australia

Aim: Cardiovascular fitness levels are significantly lower in stroke survivors compared to the general population, which limits participation in everyday activities. Meta-analysis favours the efficacy of aerobic exercise on fitness (VO₂ peak) following stroke, whilst the effect on mood and quality of life (QOL) is not yet known.  The optimal dosage and intensity of cardiovascular fitness training following stroke is unclear. The primary hypothesis was that the addition of moderate-intensity fitness training to ‘usual’ rehabilitation following stroke is feasible and safe to conduct. Secondary hypotheses were that this training will improve fitness (VO₂ peak), walking capacity and speed, depression and QOL, when compared to a low-intensity control exercise.

Method: This study was a pilot, prospective, patient- and assessor-blinded parallel group randomised controlled trial of 20 participants, conducted in the Community Based Rehabilitation centre of a tertiary, metropolitan hospital.  Eligibility criteria included ambulant stroke survivors (>100m) who were at least 6 weeks post stroke and medically stable. Participants were randomly allocated to moderate-intensity fitness training or ‘low-intensity’ control exercise; attended 2 sessions for 12 weeks; and completed a home exercise program. The primary outcome measure was VO₂ peak; secondary outcomes were functional independence (6 minute walk test, 10m walk test), QOL (SF-36) and depression (PHQ-9). Patient demographics, attendance, adherence to training parameters and home exercise compliance were recorded.

Results: 20 participants were recruited.  Statistical analyses will be available to present including safety, feasibility, the effect size for power analysis, between-group and within- group differences. Participant capacity to adhere to training parameters will be examined

Significance of the findings to allied health: This study will contribute to optimising outcomes in post stroke rehabilitation and functional participation.