Article

Ambulatory subjects after stroke may benefit from
gait-oriented cardiovascular fitness training, but trials to date have not
primarily assessed older persons. METHODS: Thirty-eight subjects (age >60 years)
with residual hemiparetic gait were enrolled >6 months after stroke. Participants
were randomized to receive 3 months (3x/week) progressive graded, high-intensity
aerobic treadmill exercise (TAEX) or conventional care physiotherapy. Primary
outcome measures were peak exercise capacity (Vo(2peak)) and sustained walking
capacity in 6-minute walks (6MW). Secondary measures were gait velocity in 10-m
walks, Berg Balance Scale, functional leg strength (5 chair-rise), self-rated
mobility (Rivermead Mobility Index), and quality of life (SF-12). RESULTS:
Thirty-six participants completed the study (18 TAEX, 18 controls). TAEX but not
conventional care improved Vo(2peak) (difference 6.4 mL/kg/min, P < .001) and 6MW
(53 m, P < .001). Likewise, maximum walking speed (0.13 m/s, P = .01), balance (P
< .05), and the mental subscore of the SF-12 (P < .01) improved more after TAEX.
Gains in Vo(2peak) correlated with the degree at which training intensity could
be progressed in the individual participant (P < .01). Better walking was related
to progression in treadmill velocity and training duration (P < .001). Vo(2peak)
and 6MW performances were still higher 1 year after the end of training when
compared with the baseline, although endurance walking (6MW) at 1 year was lower
than immediately after training (P < .01). CONCLUSION:
This trial demonstrates
that TAEX effectively improves cardiovascular fitness and gait in persons with
chronic stroke.

Langue : ANGLAIS