Early post-stroke physical conditioning in hemiplegic patients: A preliminary study

Abstract

Objective: To establish the value of an early post-stroke evaluation of cardiorespiratory fitness in hemiparetic patients using a one-leg cycling exercise test and to analyze the impact of an adapted physical activity programme 12 weeks after the stroke.

Protocol: Eighteen hemiparetic stroke patients participated in the study. The subjects were randomly assigned to one of two groups: the control group (CG) underwent 4 weeks of conventional rehabilitation, whereas the training group (TG) performed additional physical exercises. The initial evaluation (T1) was carried out after 1 week of exercise and the final evaluation (T2) was performed after 28 days. Both evaluations consisted of maximal graded tests performed with the valid leg, followed by completion of a questionnaire on personal autonomy in activities of daily living (ADL).

Results: In the CG group, we recorded a 4 to 8% increase in peak oxygen uptake (VO₂ peak). There was no significant increase in peak power output (Wpeak). However, the TG displayed significantly (P<0.05) greater peak values than those recorded on study entry (Wpeak: +30%, VO₂ peak: +20%). The TG showed a statistically significant improvement in the Barthel and Katz ADL scale scores, whereas the pre- and post-rehabilitation values did not differ significantly in the CG. However, there was no correlation between the Barthel/Katz scale scores and Wpeak.

Conclusion: Evaluation of cardiorespiratory fitness by using the valid leg seems to be feasible in hemiplegic patients 1 month post-stroke. Early post-stroke physical training appears to be needed to limit the negative effects of functional hypoactivity.