Higher Treadmill Training Intensity to Address Functional Aerobic Impairment after Stroke

Peak aerobic capacity (VO2 peak) is severely worsened after disabling stroke, having serious implications for function, metabolism, and ongoing cardiovascular risk. Various research has shown that modest improvements in VO2 peak are possible in stroke participants with aerobic exercise training. The purpose of this study was to test the extent to which greater enhancements in VO2 peak after stroke are possible by comparing the use of a progressive intensity programme and a normal training rogramme. This was achieved through a RCT measuring  change in VO2 peak, 6-minute walk distance (6MWD), 30-ft walk times (30WT), and 48-hour step counts (48SC). The intensity based programme aimed to reach 80% heart rate reserve [HRR]) with those undergoing lower intensity treadmill training 50% HRR as well as training for longer in an effort to approximately match workload/caloric expenditure.  High intensity participants (n = 18) had significantly greater gains in VO2 peak (+34%) than low intensity participants (n = 16; +5%) across the 6-month intervention period (P = .001, group × time interaction). Conversely, there was no statistical difference between groups in the changes observed for 6MWD, 30WT, or 48SC.

High intensity is far more effective than LO-TM for improving VO2 peak after disabling stroke. The magnitude of relative improvement for high intensity was double compared with previous reports from our laboratory with probable clinical significance for this population.