The feasibility of an endurance-training program in patients with central nervous system damage

Objective Patient's endurance capacities are decreased after a central nervous system damage. Due to their motor impairment, the cardiorespiratory capacity assessment is compromised. The goal of this study was to assess the feasibility of an endurance-training program, without an exercise stress test but with cardiologic predefined parameters. Material/patients and methods An individualized endurance training program of 30 sessions divided into 3 sessions per week, was developed from predefined cardiovascular criteria: the heart rate (HR) throughout the exercise must be lower than that defined by Karvonen formula [Training HR = resting HR + 0.6 (220 – age – resting HR)] and the blood pressure (BP) must be lower or equal to 190 mmHg. Based on these criteria, exercise's duration and power were adjusted to obtain, in the first session, an exercise duration of 20 minutes with a perceived exertion ≤ 11/20, assessed with Borg scale. The duration and the power were gradually increased respecting a perceived exertion ≤ 12/20, to obtain, at the fifth session an exercise duration of 30 minutes. For next sessions, the duration of the effort was 30 minutes and the power was gradually increased and adjusted to keep a perceived exertion ≤ 14/20. Results Twenty-eight patients [age 51.3 ± 12.6, ratio M/F: 15/13, stroke: 19 (68%)] have fully underwent the first session of this program. Eleven have been assessed onto an arm motor driven, 11 onto a leg motor driven and 6 on a treadmill. Throughout the session, the perceived exertion was 12 ± 2, the training HR has been reached for only two patients and the blood pressure was lower than 180 mmHg for all patients. Discussion – conclusion This endurance training program can be proposed in patients after central nervous system damage to improve their endurance capacities.