Intensifying Functional Task Practice to Meet Aerobic Training Guidelines in Stroke Survivors.

To determine whether stroke survivors could maintain workloads during functional task practice that can reach moderate levels of cardiometabolic stress (i.e., ≥40% oxygen uptake reserve ([Formula: see text]OR) for ≥20 min) without the use of ergometer-based exercise. Cross-sectional study using convenience sampling. Research laboratory in a tertiary rehabilitation hospital. Chronic hemiparetic stroke survivors (>6-months) who could provide consent and walk with or without assistance. A single bout of intermittent functional training (IFT). The IFT protocol lasted 30 min and involved performing impairment specific multi-joint task-oriented movements structured into circuits lasting ~3 min and allowing 30-45 s recovery between circuits. The aim was to achieve an average heart rate (HR) 30-50 beats above resting without using traditional ergometer-based aerobic exercise. Attainment of indicators for moderate intensity aerobic exercise. Oxygen uptake ([Formula: see text]O), carbon dioxide production ([Formula: see text]CO), and HR were recorded throughout the 30 min IFT protocol. Values were reported as percentage of [Formula: see text]OR, HR reserve (HRR) and HRR calculated from predicted maximum HR (HRR), which were determined from a prior maximal graded exercise test. Ten (3-female) chronic (38 ± 33 months) stroke survivors (70% ischemic) with significant residual impairments (NIHSS: 3 ± 2) and a high prevalence of comorbid conditions (80% ≥ 1) participated. IFT significantly increased all measures of exercise intensity compared to resting levels: [Formula: see text]O (Δ 820 ± 290 ml min, < 0.001), HR (Δ 42 ± 14 bpm, < 0.001), and energy expenditure (EE; Δ 4.0 ± 1.4 kcal min, < 0.001). Also, mean values for percentage of [Formula: see text]OR (62 ± 19), HRR (55 ± 14), and HRR (52 ± 18) were significantly higher than the minimum threshold (40%) indicating achievement of moderate intensity aerobic exercise ( = 0.004, 0.016, and 0.043, respectively). Sufficient workloads to achieve moderate levels of cardiometabolic stress can be maintained in chronic stroke survivors using impairment-focused functional movements that are not dependent on ergometers or other specialized equipment.