Article

Stroke is associated with muscle atrophy and weakness, mobility
deficits, and cardiorespiratory deconditioning. Aerobic and resistance training
(AT and RT) each have the potential to improve deficits, yet there is limited
evidence on the utility of combined training. OBJECTIVE: To examine the effects
of AT+RT versus AT on physiological outcomes in chronic stroke with motor
impairments. METHODS: Participants (n = 73) were randomized to 6 months of AT (5
d/wk) or AT+RT (3 and 2 d/wk, respectively). Outcomes included those related to
body composition by dual-energy X-ray absorptiometry, mobility (6-minute walk
distance [6MWD], sit-to-stand, and stair climb performance), cardiorespiratory
fitness (VO2peak, oxygen uptake at the ventilatory threshold [VO2VT]), and
muscular strength. RESULTS: A total of 68 (93.2%) participants (age, mean +/- SD
= 63.7 +/- 11.9) completed the study. AT+RT and AT yielded similar and
significant improvements in 6MWD (39.9 +/- 55.6 vs 36.5 +/- 63.7 m, P = .8),
VO2peak (16.4% +/- 43.8% vs 15.2% +/- 24.7%, P = .9), sit-to-stand time (-2.3 +/-
5.1 vs 1.02 +/- 9.5 s, P = .05), and stair climb performance (8.2% +/- 19.6% vs
7.5% +/- 23%, P = .97), respectively. AT+RT produced greater improvements than AT
alone for total body lean mass (1.23 +/- 2.3 vs 0.27 +/- 1.6 kg, P = .039),
predominantly trunk ( P = .02) and affected-side limbs ( P = .04), VO2VT (19.1%
+/- 26.8% vs 10.5% +/- 28.9%, P = .046), and upper- and lower-limb muscular
strength ( P < .03, all except affected-side leg). CONCLUSION: Despite being
prescribed 40% less AT, AT+RT resulted in similar and significant improvement in
mobility and VO2peak, superior improvements in VO2VT and muscular strength, and
an almost 5-fold greater increase in lean mass compared with AT. RT is the most
neglected exercise component following stroke but should be prescribed with AT
for metabolic, cardiorespiratory, and strength recovery.

Langue : ANGLAIS