Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
BMJ Open. 2020 Jun 30;10(6):e035740. doi: 10.1136/bmjopen-2019-035740.
Regular exercise is essential in the chronic phase of stroke recovery for improving or maintaining function, and reducing the risk of a second stroke. To achieve these goals, multiple components of fitness should be targeted with poststroke exercise, including aerobic capacity, strength and balance. However, following the recommended frequency and duration of each component separately can take a long time and lead to fatigue in people with stroke. Therefore, finding types of exercise that target multiple components of fitness all together is valuable.Reactive balance training (RBT) is a novel type of exercise where individuals repeatedly lose their balance in order to practise balance reactions. When people do RBT, they increase their heart rate and exert forces with their leg muscles which could improve aerobic fitness and muscle strength, respectively. This means that RBT could have the potential to improve multiple components of fitness, simultaneously.
This is a randomised controlled non-inferiority trial with internal pilot study. Participants with chronic stroke will be randomly assigned to one of two groups: (1) RBT or (2) aerobic and strength training (AST). Participants in both groups will complete 1 hour of exercise, three times/week for 12 weeks. The primary objective is to determine the effect of RBT on aerobic capacity and knee muscles' strength. The secondary objective is to determine the effects of RBT and AST on balance control and balance confidence. We expect to find that RBT is superior to AST in terms of improving balance control and balance confidence, yet not inferior to AST in terms of its effects on aerobic capacity and strength.
Research ethics approval has been received. Results will be disseminated directly to study participants at the end of the trial, and to other stakeholders via publication in a peer-reviewed journal.
NCT04042961.
规律运动对于改善或维持脑卒中后的功能、降低再次发生脑卒中的风险至关重要。为了实现这些目标，脑卒中后运动应针对多个健康要素，包括有氧能力、力量和平衡。然而，单独按照每个要素的推荐频率和时长进行训练可能需要很长时间，并且会使脑卒中患者感到疲劳。因此，寻找同时针对多个健康要素的运动类型是很有价值的。反应性平衡训练（RBT）是一种新的运动类型，个体通过反复失去平衡来练习平衡反应。当人们进行 RBT 时，他们会增加心率并使腿部肌肉发力，这分别可以改善有氧健康和肌肉力量。这意味着 RBT 有可能同时改善多个健康要素。
这是一项具有内部预试验的随机对照非劣效性试验。慢性脑卒中患者将被随机分配到以下两组之一：（1）RBT 或（2）有氧和力量训练（AST）。两组参与者都将完成 1 小时的运动，每周 3 次，持续 12 周。主要目标是确定 RBT 对有氧能力和膝关节肌肉力量的影响。次要目标是确定 RBT 和 AST 对平衡控制和平衡信心的影响。我们预计 RBT 在改善平衡控制和平衡信心方面优于 AST，但在改善有氧能力和力量方面并不劣于 AST。
已获得研究伦理批准。试验结束后，将直接向研究参与者传播研究结果，并通过在同行评议期刊上发表文章向其他利益相关者传播结果。
NCT04042961。
