Department of Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH, USA.
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Neurorehabil Neural Repair. 2024 Apr;38(4):291-302. doi: 10.1177/15459683241233577. Epub 2024 Feb 29.
The potential for aerobic exercise (AE) to enhance neuroplasticity post-stroke has been theorized but not systematically investigated. Our aim was to determine the effects of forced-rate AE (FE) paired with upper extremity (UE) repetitive task practice (FE + RTP) compared to time-matched UE RTP (RTP only) on motor recovery.
A single center randomized clinical trial was conducted from April 2019 to December 2022. Sixty individuals ≥6 months post-stroke with UE hemiparesis were randomized to FE + RTP (N = 30) or RTP only (N = 30), completing 90-minute sessions, 3×/week for 8 weeks. The FE + RTP group underwent 45-minute of FE (5-minute warm-up, 35-minute main set, and 5-minute cool down) followed by 45-minute of UE RTP. The RTP only group completed 90-minute of RTP. Primary outcomes were the Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT). The 6-minute Walk Test (6MWT, secondary outcome) assessed walking capacity.
Sixty individuals enrolled and 56 completed the study. The RTP only group completed more RTP in terms of repetitions (411.8 ± 44.4 vs 222.8 ± 28.4, < .001) and time (72.7 ± 6.7 vs 37.8 ± 2.4 minutes, < .001) versus FE + RTP. There was no significant difference between groups on the FMA (FE + RTP, 36.2 ± 10.1-44.0 ± 11.8 and RTP only, 34.4 ± 11.0-41.2 ± 13.4, = .43) or ARAT (FE + RTP, 32.5 ± 16.6-37.7 ± 17.9 and RTP only, 32.8 ± 18.6-36.4 ± 18.5, = .88). The FE + RTP group demonstrated greater improvements on the 6MWT (274.9 ± 122.0-327.1 ± 141.2 m) versus RTP only (285.5 ± 160.3-316.9 ± 170.0, = .003).
There was no significant difference between groups in the primary outcomes. The FE + RTP improved more on the 6MWT, a secondary outcome.
ClinicalTrials.gov: NCT03819764.
有氧运动（AE）增强中风后神经可塑性的潜力已被提出，但尚未系统研究。我们的目的是确定强制速率 AE（FE）与上肢（UE）重复任务练习（FE + RTP）相结合与仅 UE RTP（仅 RTP）相比，对运动恢复的影响。
一项单中心随机临床试验于 2019 年 4 月至 2022 年 12 月进行。60 名中风后≥6 个月且存在 UE 偏瘫的患者被随机分为 FE + RTP（n = 30）或仅 RTP（n = 30）组，每组完成 90 分钟的疗程，每周 3 次，持续 8 周。FE + RTP 组进行 45 分钟的 FE（5 分钟热身，35 分钟主集，5 分钟冷却），然后进行 45 分钟的 UE RTP。仅 RTP 组完成 90 分钟的 RTP。主要结局是 Fugl-Meyer 评估（FMA）和动作研究上肢测试（ARAT）。6 分钟步行测试（6MWT，次要结局）评估步行能力。
共有 60 名患者入组，56 名患者完成了研究。仅 RTP 组在重复次数（411.8 ± 44.4 与 222.8 ± 28.4， <.001）和时间（72.7 ± 6.7 与 37.8 ± 2.4 分钟， <.001）方面完成了更多的 RTP。FE + RTP 组与 RTP 组相比，FMA（FE + RTP，36.2 ± 10.1-44.0 ± 11.8 和 RTP 仅，34.4 ± 11.0-41.2 ± 13.4， =.43）或 ARAT（FE + RTP，32.5 ± 16.6-37.7 ± 17.9 和 RTP 仅，32.8 ± 18.6-36.4 ± 18.5， =.88）无显著差异。FE + RTP 组在 6MWT（274.9 ± 122.0-327.1 ± 141.2 m）方面的改善优于 RTP 组（285.5 ± 160.3-316.9 ± 170.0， =.003）。
两组主要结局无显著差异。FE + RTP 组在次要结局 6MWT 上的改善更大。
ClinicalTrials.gov：NCT03819764。
