Predictors of improved aerobic capacity in individuals with chronic stroke participating in cycling interventions

Oh, what stupidity. PREDICTION CRAPOLA RATHER THAN PROTOCOLS THAT INCREASE AEROBIC CAPACITY. 

Predictors of improved aerobic capacity in individuals with chronic stroke participating in cycling interventions

Archives of Physical Medicine and Rehabilitation , Volume 101(4) , Pgs. 717-721.

NARIC Accession Number: J83783.  What's this?
ISSN: 0003-9993.
Author(s): Linder, Susan M. ; Davidson, Sara ; Rosenfeldt, Anson ; Penko, Amanda ; Lee, John ; Koop, Mandy M. ; Phelan, Dermot ; Alberts, Jay L..
Publication Year: 2020.
Number of Pages: 5.

Abstract: 

Study identified demographic and physiological factors that predict improvement in aerobic capacity among individuals with chronic stroke participating in cycling interventions. Forty-four participants were randomized to one of three interventions: (1) forced aerobic exercise and upper extremity repetitive task practice (UERTP), (2) voluntary aerobic exercise (VE) and UERTP, or (3) a nonaerobic control group. All interventions were time-matched and occurred 3 times per week for 8 weeks. The primary outcome was aerobic capacity as measured by peak oxygen consumption (VO2peak) per unit time during maximal cardiopulmonary exercise stress testing. Significant improvements in VO2peak were observed from baseline to postintervention in the VE+UERTP group. Considerable variability was observed among participants relating to postintervention change in VO2peak. Among aerobic exercise participants, a multivariate regression analysis revealed that cycling cadence, baseline VO2peak, and group allocation were significant predictors of change in VO2peak. High exercise rate (cycling cadence) appears to be an important variable in improving aerobic capacity and should be considered when prescribing aerobic exercise for individuals with chronic stroke. The findings suggest that those with low VO2peak at baseline may benefit the most from aerobic interventions as it relates to cardiorespiratory fitness.
Descriptor Terms: CARDIOPULMONARY FUNCTION, CLIENT CHARACTERISTICS, DEMOGRAPHICS, EXERCISE, HEMIPLEGIA, PHYSIOLOGY, STROKE, TASK ANALYSIS.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Linder, Susan M. , Davidson, Sara , Rosenfeldt, Anson , Penko, Amanda , Lee, John , Koop, Mandy M. , Phelan, Dermot , Alberts, Jay L.. (2020). Predictors of improved aerobic capacity in individuals with chronic stroke participating in cycling interventions.  Archives of Physical Medicine and Rehabilitation , 101(4), Pgs. 717-721. Retrieved 7/18/2020, from REHABDATA database.

Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study

I biked to work for 27 years prior to my stroke, 4 miles each way 9-10 months out of the year.
Still had a stroke, that was not enough to keep my arteries clear. I'm sure that my cardiovascular fitness was what allowed me to survive my stroke. 

Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study 

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1456 (Published 19 April 2017) Cite this as: BMJ 2017;357:j1456

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1. Carlos A Celis-Morales, research associate1,
2. Donald M Lyall, research associate2,
3. Paul Welsh, senior lecturer1,
4. Jana Anderson, research associate2,
5. Lewis Steell, postgraduate student1,
6. Yibing Guo, postgraduate student1,
7. Reno Maldonado, postgraduate student1,
8. Daniel F Mackay, reader2,
9. Jill P Pell, professor2,
10. Naveed Sattar, professor1,
11. Jason M R Gill, reader1

Author affiliations

1. Correspondence to: J M R Gill jason.gill@glasgow.ac.uk

• Accepted 16 March 2017

Abstract

Objective To investigate the association between active commuting and incident cardiovascular disease (CVD), cancer, and all cause mortality.

Design Prospective population based study.

Setting UK Biobank.

Participants 263 450 participants (106 674 (52%) women; mean age 52.6), recruited from 22 sites across the UK. The exposure variable was the mode of transport used (walking, cycling, mixed mode v non-active (car or public transport)) to commute to and from work on a typical day.

Main outcome measures Incident (fatal and non-fatal) CVD and cancer, and deaths from CVD, cancer, or any causes.

Results 2430 participants died (496 were related to CVD and 1126 to cancer) over a median of 5.0 years (interquartile range 4.3-5.5) follow-up. There were 3748 cancer and 1110 CVD events. In maximally adjusted models, commuting by cycle and by mixed mode including cycling were associated with lower risk of all cause mortality (cycling hazard ratio 0.59, 95% confidence interval 0.42 to 0.83, P=0.002; mixed mode cycling 0.76, 0.58 to 1.00, P<0.05), cancer incidence (cycling 0.55, 0.44 to 0.69, P<0.001; mixed mode cycling 0.64, 0.45 to 0.91, P=0.01), and cancer mortality (cycling 0.60, 0.40 to 0.90, P=0.01; mixed mode cycling 0.68, 0.57 to 0.81, P<0.001). Commuting by cycling and walking were associated with a lower risk of CVD incidence (cycling 0.54, 0.33 to 0.88, P=0.01; walking 0.73, 0.54 to 0.99, P=0.04) and CVD mortality (cycling 0.48, 0.25 to 0.92, P=0.03; walking 0.64, 0.45 to 0.91, P=0.01). No statistically significant associations were observed for walking commuting and all cause mortality or cancer outcomes. Mixed mode commuting including walking was not noticeably associated with any of the measured outcomes.

Conclusions Cycle commuting was associated with a lower risk of CVD, cancer, and all cause mortality. Walking commuting was associated with a lower risk of CVD independent of major measured confounding factors. Initiatives to encourage and support active commuting could reduce risk of death and the burden of important chronic conditions.

Aerobic fitness is associated with low cardiovascular disease risk: The impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - The Lifestyle, Biomarker, and Atherosclerosis study

I was incredibly fit and still suffered an ischemic stroke, of course the carotid dissection probably occurred during exertions on my 6 day, 21 mile whitewater canoe trip, with portages up to 1.5 miles. My extreme fitness caused my stroke but also probably saved my life after the stroke occurred. 

Aerobic fitness is associated with low cardiovascular disease risk: The impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - The Lifestyle, Biomarker, and Atherosclerosis study

Vascular Health and Risk Management

Fernstrom M, et al.

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The objectives of the study portrayed in this paper were to evaluate selected cardiometabolic biomarkers, carotid intima–media thickness (cIMT) as a marker of subclinical atherosclerosis, and lifestyle–associated indicators (food habits, handgrip strength, and oxygen uptake, VO₂ max); examine the relationship between cIMT and lifestyle factors; and recognize subjects at risk of cardiovascular disease (CVD) utilizing a risk score and to compare the characteristics of subjects with and without risk of CVD. High aerobic fitness is related to low CVD risk in Swedish young adults. The high prevalence of young adults observed with unfavorable levels of high–density lipoprotein cholesterol and homeostasis model assessment of insulin resistance raises concerns about future CVD risk.

Methods

• They collected blood samples in a fasting state, and food habits were reported through a questionnaire.
• In this study, cIMT was measured by ultrasound, and VO₂ max was measured by ergometer bike test.
• The risk score was calculated according to Wildman.

Results

• In this study, they found cIMT (mean ± standard deviation) was 0.50±0.06 mm, and VO₂ max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively.
• No correlation was found between aerobic fitness expressed as VO₂ max (mL/kg/min) and cIMT.
• By using Wildman’s definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance.
• An aggregate of 35% of women and 25% of men had lower high–density lipoprotein cholesterol than suggested.
• Food habits did not differ between those at risk and those not at risk.
• However, aerobic fitness measured as VO₂ max (mL/kg/min) differed; 47% of the subjects at risk had low aerobic fitness compared to 23% of the nonrisk subjects (P<0.001).

Estimated Prestroke Peak VO2 Is Related to Circulating IGF-1 Levels During Acute Stroke

The real trial needed is whether IGF-1 can be improved post-stroke and will that lead to better recoveries? Survivors don't really care that peak VO₂ prestroke leads to better IGF-1 and better recoveries. What can be done post-stroke that leads to better recovery? I had incredible aerobic fitness and that probably saved my life, didn't seem to help with my arm and hand recovery. 

Estimated Prestroke Peak VO2 Is Related to Circulating IGF-1 Levels During Acute Stroke 

1. Anna E. Mattlage, PhD1
2. Michael A. Rippee, MD1
3. Michael G. Abraham, MD1
4. Janice Sandt, MS2
5. Sandra A. Billinger, PhD1⇑

1. ¹University of Kansas Medical Center, Kansas City, KS, USA
2. ²University of Kansas Hospital, Kansas City, KS, USA

1. Sandra A. Billinger, University of Kansas Medical Center, Department of Physical Therapy and Rehabilitation Science, 3901 Rainbow Blvd, Mail Stop 2002, Kansas City, KS 66160, USA. Email: sbillinger@kumc.edu

Abstract

Background. Insulin-like growth factor-1 (IGF-1) is neuroprotective after stroke and is regulated by insulin-like binding protein-3 (IGFBP-3). In healthy individuals, exercise and improved aerobic fitness (peak oxygen uptake; peak VO₂) increases IGF-1 in circulation. Understanding the relationship between estimated prestroke aerobic fitness and IGF-1 and IGFBP-3 after stroke may provide insight into the benefits of exercise and aerobic fitness on stroke recovery.  

Objective. The purpose of this study was to determine the relationship of IGF-1 and IGFBP-3 to estimated prestroke peak VO₂ in individuals with acute stroke. We hypothesized that (1) estimated prestroke peak VO₂ would be related to IGF-1 and IGFBP-3 and (2) individuals with higher than median IGF-1 levels will have higher estimated prestroke peak VO₂ compared to those with lower than median levels.  

Methods. Fifteen individuals with acute stroke had blood sampled within 72 hours of hospital admission. Prestroke peak VO₂ was estimated using a nonexercise prediction equation. IGF-1 and IGFBP-3 levels were quantified using enzyme-linked immunoassay. Results. Estimated prestroke peak VO₂ was significantly related to circulating IGF-1 levels (r = .60; P = .02) but not IGFBP-3. Individuals with higher than median IGF-1 (117.9 ng/mL) had significantly better estimated aerobic fitness (32.4 ± 6.9 mL kg⁻¹ min⁻¹) than those with lower than median IGF-1 (20.7 ± 7.8 mL kg⁻¹ min⁻¹; P = .03). 

Conclusions. Improving aerobic fitness prior to stroke may be beneficial by increasing baseline IGF-1 levels. These results set the groundwork for future clinical trials to determine whether high IGF-1 and aerobic fitness are beneficial to stroke recovery by providing neuroprotection and improving function.

How strongly is aerobic capacity correlated with walking speed and distance after stroke? Systematic review and meta-analysis

My aerobic capacity should have been off the charts but my walking speed at first was atrocious because of foot drop and then the problem became spasticity of the leg that didn't allow the lower leg to swing straight and freely.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J72109&phrase=no&rec=128903
NARIC Accession Number: J72109.  What's this?
ISSN: 0031-9023.
Author(s): Outermans, Jacqueline; van de Port, Ingrid; Wittink, Harriet; de Groot, Janke; Kwakkel, Gert.
Publication Year: 2015.
Number of Pages: 19.
Abstract: This systematic review summarized the available evidence on the correlation between peak oxygen consumption (VO2peak) and walking capacity. Restoration of walking capacity, expressed as walking speed and walking distance, is a primary goal after stroke. Peak aerobic capacity (measured as VO2peak) is suggested to be correlated with walking capacity after stroke. Although the strength of this correlation is unclear, physical therapy programs often target walking capacity by means of aerobic training. The MEDLINE, CINAHL, EMBASE, Cochrane Library, and SPORTDiscus databases were searched up to May 2014 for cross-sectional studies reporting correlation coefficients between VO2peak and walking capacity in stroke, along with longitudinal studies reporting these correlation coefficients at baseline. Thirteen studies involving 454 participants were included. The methodological quality of the studies was assessed using a checklist of 27 items for observational research. Information on study design, stroke severity and recovery, and assessments and outcome of VO2peak and walking capacity, as well as the reported correlation coefficients, were extracted. Meta-analyses showed combined correlation coefficients for VO2peak and walking speed and for VO2peak and walking distance of .42 and .52, respectively. The results indicate a low positive combined correlation coefficient between VO2peak and walking speed and a moderate combined positive correlation between VO2peak and walking distance that were both statistically significant. These findings suggest that other factors, such as age, balance, stroke severity, or lower-extremity muscle strength, may influence the correlation between VO2peak and walking capacity.