AExaCTT – Aerobic Exercise and Consecutive Task-specific Training for the upper limb after stroke: Protocol for a randomised controlled pilot study

If you can do these hours of training you are already high functioning so this research will tell you nothing. With my spasticity I could really do no upper arm exercises until that spasticity is cured. No talk of fixing that. 
http://www.sciencedirect.com/science/article/pii/S2451865416301296?

Under a Creative Commons license

Abstract

Motor function may be enhanced if aerobic exercise is paired with motor training. One potential mechanism is that aerobic exercise increases levels of brain-derived neurotrophic factor (BDNF), which is important in neuroplasticity and involved in motor learning and motor memory consolidation. This study will examine the feasibility of a parallel-group assessor-blinded randomised controlled trial investigating whether task-specific training preceded by aerobic exercise improves upper limb function more than task-specific training alone, and determine the effect size of changes in primary outcome measures. People with upper limb motor dysfunction after stroke will be allocated to either task-specific training or aerobic exercise and consecutive task-specific training. Both groups will perform 60 hours of task-specific training over 10 weeks, comprised of 3 × 1 hour sessions per week with a therapist and 3 × 1 hours of home-based self-practice per week. The combined intervention group will also perform 30 minutes of aerobic exercise (70–85%HR_max) immediately prior to the 1 hour of task-specific training with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events will be recorded. Clinical outcome measures will be performed pre-randomisation at baseline, at completion of the training program, and at 1 and 6 months follow-up. Primary clinical outcome measures will be the Action Research Arm Test (ARAT) and the Wolf Motor Function Test (WMFT). If aerobic exercise prior to task-specific training is acceptable, and a future phase 3 randomised controlled trial seems feasible, it should be pursued to determine the efficacy of this combined intervention for people after stroke.

Keywords

Stroke

Motor function

Aerobic exercise

Task-specific training

Abbreviations

ARAT

Action Research Arm Test

BDNF

brain-derived neurotrophic factor

CERT

Consensus on Exercise Reporting Template

CM

centimetre

CONSORT

Consolidated Standards of Reporting Trials

ECG

electrocardiography

ELISA

enzyme-linked immunosorbent assay

FAS

Fatigue Assessment Scale

GP

general practitioner

HR_max

age-predicted maximal heart rate maximum

HR_peak

peak heart rate

IPAQ

International Physical Activity Questionnaire

MAL

Motor Activity Log

mL.kg⁻¹.min⁻¹

millilitres per kilogram per minute

MRI

magnetic resonance imaging

MS

Microsoft

m/s

millimetres per second

NAA

N-acetyl Aspartate

PV

Peak Velocity

PD

Peak Deceleration

REDCap

Research Electronic Data Capture

reps

repetitions

RPE

rating of perceived exertion

RPM

revolutions per minute

SIS

Stroke Impact Scale

s

seconds

VO₂

oxygen uptake

VO_2peak

peak oxygen uptake

WMFT

Wolf Motor Function Test

6MWT

Six Minute Walk Test