Moderate-to-high Intensity Group Exercise Improves Function of Stroke Survivors
Se Hee Jung1, Hyejung Cho1, Gilhyeon Yoon1
1Seoul National University Boramae Medical Center
Objective:

The aim of this study is to investigate the effect and feasibility of moderate-to-high intensity exercise in stroke survivors.

Background:
Post-stroke exercise need to be encouraged to facilitate optimal recovery and to improve both physical and mental health. However, stroke survivors are easily predisposed to sedentary lifestyle due to physical impairment and functional compromise. Moreover, many clinicians as well as patients tend to be discouraged by exercise-related risk of injury of falls or comorbidities.

Design/Methods:

This study is a randomized controlled trial. Subjects were randomly assigned to either intervention or control group. Subjects in intervention group completed 16 sessions of 90-minute moderate-to-high intensity group-based exercise for 8 weeks.

Isometric muscle strength and grip strength of the affected and unaffected side, 10 repetition sit-to-stand test (STS10), 60 second sit-to-stand test (STS60), Short Physical Performance Battery (SPPB), multidirectional reach test, Berg’s Balance scale (BBS), 10-meter walk test, 6 minute walk test, Timed-up-and-go test, physiological cost index, Korean version of modified Barthel index, and Korean version of Montreal Cognitive Assessment (MoCA-K) were measured at baseline and postintervention.

Results:

Total 30 stroke survivors were enrolled in the study and 22 were randomized to group-based moderate-to-high exercise and 8 were randomzied to home-based low intensity exercise. Intervention group showed high compliance as well as high attendance rate. Adverse event was only 2 uneventful falls in 1 subject. 

After 8 weeks of moderate-to-high intensity group exercise, subjects showed significant improvement in isometric muscle strength of hip extensors and knee flexors and grip strength both in affected and unaffected limbs, and isometric muscle strength of affected shoulder abductor. Also, STS60, SPPB, BBS, and MoCA-K were significantly improved in the intervention group after 8-week of moderate-to-high intensity exercise. 

Conclusions:

Moderate-to-high intensity group-based exercise is feasible and safe and improves physical and cognitive function of chronic stroke survivors. 

10.1212/WNL.0000000000202350