Abstract
Background.
The recovery of motor function following stroke is largely dependent on
motor learning–related neuroplasticity. It has been hypothesized that
intensive aerobic exercise (AE) training as an antecedent to motor task
practice may prime the central nervous system to optimize motor recovery
poststroke.
Objective. The objective of this study was to
determine the differential effects of forced or voluntary AE combined
with upper-extremity repetitive task practice (RTP) on the recovery of
motor function in adults with stroke.
Methods. A combined
analysis of 2 preliminary randomized clinical trials was conducted in
which participants (n = 40) were randomized into 1 of 3 groups: (1)
forced exercise and RTP (FE+RTP), (2) voluntary exercise and RTP
(VE+RTP), or (3) time-matched stroke-related education and RTP
(Edu+RTP). Participants completed 24 training sessions over 8 weeks.
Results.
A significant interaction effect was found indicating that improvements
in the Fugl-Meyer Assessment (FMA) were greatest for the FE+RTP group (P
= .001). All 3 groups improved significantly on the FMA by a mean of
11, 6, and 9 points for the FE+RTP, VE+RTP, and Edu+RTP groups,
respectively. No evidence of a treatment-by-time interaction was
observed for Wolf Motor Function Test outcomes; however, those in the
FE+RTP group did exhibit significant improvement on the total, gross
motor, and fine-motor performance times (P ≤ .01 for all observations).
Conclusions.
Results indicate that FE administered prior to RTP enhanced motor skill
acquisition greater than VE or stroke-related education. AE, FE in
particular, should be considered as an effective antecedent to enhance
motor recovery poststroke.
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