Forced and voluntary aerobic cycling interventions improve walking capacity in individuals with chronic stroke.

ABSTRACT Objectives To determine the efficacy of high-intensity cycling to improve walking capacity in persons with chronic stroke, identify variables that predict improvement in walking capacity, and quantify the relationship between Six Minute Walk Test (6MWT) and Cardiopulmonary Exercise (CPX) Test variables. Design Secondary analysis of data from 2 randomized clinical trials Setting Research laboratory Participants Individuals with chronic stroke (N=43) Interventions Participants were randomized to one of the following time-matched interventions, occurring 3 times per week for 8 weeks: 1) forced aerobic exercise and upper extremity repetitive task practice (FE+RTP, N=16), 2) voluntary aerobic exercise and upper extremity repetitive task practice (VE+RTP, N=14), or 3) a non-aerobic control group (control, N=13). Main Outcome Measure Change in walking capacity as measured by the 6MWT from baseline to end of treatment (EOT). Results Significant increases were observed in distance traveled during the 6MWT at EOT compared to baseline in the FE+RTP (p Conclusions An 8-week aerobic cycling intervention prescribed at 60-80% of heart rate reserve and moderate to high cadence and resistance led to significant improvements in walking capacity in our cohort of persons with chronic stroke. Individuals with low baseline levels of walking capacity may benefit most from aerobic cycling to improve over ground locomotion. While the 6MWT did not elicit a comparable cardiorespiratory response as the maximal exertion CPX test, the 6MWT can be considered a valid and clinically relevant submaximal test of cardiorespiratory function in individuals with chronic stroke.