Effect Of Aerobic Capacity On Rehabilitation Efficacy In Chronic Stroke Survivors

Stroke has remained a leading cause of disability for the past 30-years. With a surviving cohort of approximately 7 million individuals, which is projected to continue to grow, the need to develop rehabilitation strategies that can reduce disability, promote functional recovery, and enhance quality of life are imperative. Stroke survivors present with profound reductions in aerobic and muscular capacities and traditional rehabilitation sessions have been shown to be an insufficient stimulus to augment physical capacity. Consequently, survivors of stroke are required to work at a significantly greater relative intensity to complete activities of daily living such as walking, climbing stairs, or even making the bed. Fortunately, stroke survivors retain the capacity to adapt to exercise training, thereby reducing disability. Despite evidence of these benefits, aerobic and muscular capacity building, as a therapeutic intervention following stroke, remains clinically underutilized. However, we propose that negating its inclusion in therapy may reduce the potential efficacy of rehabilitation techniques inherently due to the relative intensity on the patient. To further investigate this proposal, we completed a retrospective data analysis of 98 chronic stroke survivors who underwent exercise-based rehabilitation interventions, with both physical function outcome measures (i.e., walking or arm function) and baseline aerobic capacity assessment or muscle capacity assessment. Participants were stratified into four groups based on baseline aerobic and muscle capacity. The group with lowest baseline aerobic and capacities demonstrated the poorest response to rehabilitation (ES = 0.47; MCID rate = 26%) whereas the group with greatest baseline aerobic and muscle capacities were most responsive to the rehabilitation interventions (ES = 1.03; MCID rate = 54%). Further research is warranted; however, results of the present analysis appear to suggest that survivors of stroke with lower levels of aerobic and muscle capacities would benefit from a comprehensive exercise training program to enhance their response to rehabilitation interventions.