Article

Aerobic treadmill exercise (T-EX) therapy has been shown to benefit
walking and cardiorespiratory fitness in stroke survivors with chronic gait
impairment even long after their stroke. The response, however, varies between individuals.
The purpose of this post hoc analysis of 2 randomized
controlled T-EX trials was to identify predictors for therapy response. METHODS:
In all, 52 participants received T-EX for 3 (Germany) or 6 (United States)
months. Improvements in overground walking velocity (10 m/6-min walk) and fitness
(peak VO(2)) were indicators of therapy response. Lesion location and volume were
measured on T1-weighted magnetic resonance scans. RESULTS: T-EX significantly
improved gait and fitness, with gains in 10-m walk tests ranging between +113%
and -25% and peak VO(2) between -12% and 88%. Baseline walking impairments or
fitness deficits were not predictive of therapy response; 10-m walk velocity
improved more in those with subcortical rather than cortical lesions and in
patients with smaller lesions. Improvements in 6-minute walk velocity were
greater in those with more recent strokes and left-sided lesions. No variable
other than training intensity, which was different between trials, predicted
fitness gains. CONCLUSIONS: Despite proving overall effectiveness, the response
to T-EX varies markedly between individuals. Whereas intensity of aerobic
training seems to be an important predictor of gains in cardiovascular fitness,
lesion size and location as well as interval between stroke onset and therapy
delivery likely affect therapy response. These findings may be used to guide the
timing of training and identify subgroups of patients for whom training
modalities could be optimized.

Langue : ANGLAIS