Feasibility Of High Intensity Functional Training In Individuals With Post-stroke Aphasia

Exercise boosts physical health in clinical populations and high intensity training (HIT) has been found to improve fitness to a greater and faster degree than moderate intensity training. However, there is a lack of research on the feasibility and safety of HIT in chronic stroke survivors, and particularly those with aphasia. PURPOSE: We studied the safety and feasibility of Aphasia Physical EXercise (APEX), a HIT program for those with post-stroke aphasia. We measured feasibility by avoidance of adverse events (e.g., injuries), high adherence rates and participants’ ability to meet the prescribed exercise intensity during individual training sessions. We also assessed APEX’s effect on functional fitness. METHODS: Six (6) adults (Age 56.17 ± 7.65 years) with chronic stroke (i.e., at least 6 months post-stroke) were recruited to participate. APEX was an 8-week HIT protocol focused on enhancing cardiovascular fitness and muscle strength while incorporating balance and mobility exercises. Participants were prescribed to reach >80% of maximal heart rate during each interval and to decrease to ~60% of maximal heart rate during each recovery interval. Heart rate was monitored using heart rate monitors and participants monitored real-time heart rate projected on a large screen. At baseline and after the 8-week training period, participants were assessed for functional fitness using the 30-second Chair Stand Test, Timed Up and Go (TUG) Test, 2-Minute Step Test, Functional Reach Test, gait speed testing and maximal aerobic capacity (VO2 max). RESULTS: APEX was found to be safe and feasible with no adverse events and a 97.3% attendance rate. Participants consistently exceeded 80% of maximal heart rate throughout the program. Additionally, improvements were seen in functional fitness (p < 0.05). CONCLUSIONS: APEX proved to be a safe and effective HIT training program for post-stroke aphasia. Heart rate goals were met during the majority of training sessions, adherence was very high and there were no recorded adverse events. These results are promising for future research on HIT programming for post-stroke aphasia. Supported by: NIDCD R56DC020700