Aerobic With Resistance Training or Aerobic Training Alone Poststroke: A Secondary Analysis From a Randomized Clinical Trial

Useless. Not written up as a protocol and not published where survivors can find it and bring it to their doctors and therapists attention.

Aerobic With Resistance Training or Aerobic Training Alone Poststroke: A Secondary Analysis From a Randomized Clinical Trial 

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Susan Marzolini, PhD¹²³

Susan Marzolini

1Toronto Rehab-University Health Network, Toronto, ON, Canada2University of Toronto, Toronto, ON, Canada3Canadian Partnership for Stroke Recovery
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, Dina Brooks, PhD¹²³

Dina Brooks

1Toronto Rehab-University Health Network, Toronto, ON, Canada2University of Toronto, Toronto, ON, Canada3Canadian Partnership for Stroke Recovery
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, Paul Oh, MD¹³

Paul Oh

1Toronto Rehab-University Health Network, Toronto, ON, Canada3Canadian Partnership for Stroke Recovery
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David Jagroop, MHSc¹⁴

David Jagroop

1Toronto Rehab-University Health Network, Toronto, ON, Canada4University of Ontario Institute of Technology, Oshawa, ON, Canada
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, Bradley J. MacIntosh, PhD³⁵

Bradley J. MacIntosh

3Canadian Partnership for Stroke Recovery5Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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, Nicole D. Anderson, PhD²³⁶

Nicole D. Anderson

2University of Toronto, Toronto, ON, Canada3Canadian Partnership for Stroke Recovery6Rotman Research Institute, Baycrest Health Sciences, Toronto, ON
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, David Alter, PhD¹⁷

David Alter

1Toronto Rehab-University Health Network, Toronto, ON, Canada7Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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, Dale Corbett, PhD³⁸*

Dale Corbett

3Canadian Partnership for Stroke Recovery8University of Ottawa, Ottawa, Canada
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...

First Published March 30, 2018 Research Article

https://doi.org/10.1177/1545968318765692

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Article Information

Article first published online: March 30, 2018

https://doi.org/10.1177/1545968318765692

Susan Marzolini, PhD^{1, 2, 3}, Dina Brooks, PhD^{1, 2, 3}, Paul Oh, MD^{1, 3}, David Jagroop, MHSc^{1, 4}, Bradley J. MacIntosh, PhD^{3, 5}, Nicole D. Anderson, PhD^{2, 3, 6}, David Alter, PhD^{1, 7}, Dale Corbett, PhD^{3, 8}*

¹Toronto Rehab-University Health Network, Toronto, ON, Canada

²University of Toronto, Toronto, ON, Canada

³Canadian Partnership for Stroke Recovery

⁴University of Ontario Institute of Technology, Oshawa, ON, Canada

⁵Sunnybrook Health Sciences Centre, Toronto, ON, Canada

⁶Rotman Research Institute, Baycrest Health Sciences, Toronto, ON

⁷Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

⁸University of Ottawa, Ottawa, Canada

Corresponding Author: Susan Marzolini, PhD, Toronto Rehab-University Health Network, 347 Rumsey Road, Toronto, ON M4G1R7, Canada. Email: Susan.marzolini@uhn.ca

*This author is a member of The American Society of Neurorehabilitation.

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Abstract

Background: Stroke is associated with muscle atrophy and weakness, mobility deficits, and cardiorespiratory deconditioning. Aerobic and resistance training (AT and RT) each have the potential to improve deficits, yet there is limited evidence on the utility of combined training.
Objective: To examine the effects of AT+RT versus AT on physiological outcomes in chronic stroke with motor impairments.  (The objective should be to write up a protocol on using this for stroke recovery, not this fucking lazy statistical mumbo jumbo.)
Methods: Participants (n = 73) were randomized to 6 months of AT (5 d/wk) or AT+RT (3 and 2 d/wk, respectively). Outcomes included those related to body composition by dual-energy X-ray absorptiometry, mobility (6-minute walk distance [6MWD], sit-to-stand, and stair climb performance), cardiorespiratory fitness (VO_2peak, oxygen uptake at the ventilatory threshold [VO_2VT]), and muscular strength.  
Results: A total of 68 (93.2%) participants (age, mean ± SD = 63.7 ± 11.9) completed the study. AT+RT and AT yielded similar and significant improvements in 6MWD (39.9 ± 55.6 vs 36.5 ± 63.7 m, P = .8), VO_2peak (16.4% ± 43.8% vs 15.2% ± 24.7%, P = .9), sit-to-stand time (−2.3 ± 5.1 vs 1.02 ± 9.5 s, P = .05), and stair climb performance (8.2% ± 19.6% vs 7.5% ± 23%, P = .97), respectively. AT+RT produced greater improvements than AT alone for total body lean mass (1.23 ± 2.3 vs 0.27 ± 1.6 kg, P = .039), predominantly trunk (P = .02) and affected-side limbs (P = .04), VO_2VT (19.1% ± 26.8% vs 10.5% ± 28.9%, P = .046), and upper- and lower-limb muscular strength (P < .03, all except affected-side leg).  
Conclusion: Despite being prescribed 40% less AT, AT+RT resulted in similar and significant improvement in mobility and VO_2peak, superior improvements in VO_2VT and muscular strength, and an almost 5-fold greater increase in lean mass compared with AT. RT is the most neglected exercise component following stroke but should be prescribed with AT for metabolic, cardiorespiratory, and strength recovery.