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Effects of Aerobic Training Post-stroke

13. maj 2019 opdateret af: Christina Danielli Coelho de Morais Faria, Federal University of Minas Gerais

Effects of Aerobic Training on Physical Activity Levels and Sedentary Behavior in Subjects Post-stroke: a Randomized Controlled Trial

Physical activity level is an important determinant of quality of life in persons post-stroke. There is a lack of knowledge regarding the effects of aerobic training on physical activity levels in subjects post-stroke. Therefore, the primary objective will be to investigate the effects of aerobic treadmill training on physical activity levels and sedentary behavior in subjects post-stroke. The secondary aim will be to investigate the effects of the training on cardiorespiratory fitness, endurance, depression, mobility, quality of life, and participation.

A randomized controlled trial with blinded assessment will assign eligible participants to either: 1) aerobic treadmill training (experimental group, at 60-80% of heart rate reserve), or 2) overground walking (control group, below 40% of heart rate reserve). Both groups will receive 40-minute training sessions three times/week over 12-weeks, in groups of 2-4 participants, by a trained physiotherapist. Primary outcomes: physical activity levels and sedentary behavior (Multisensor SenseWear Mini® and Human Activity Profile). Secondary outcomes: cardiorespiratory fitness (peak oxygen uptake (VO2peak) and ventilatory threshold), endurance, depression, mobility, quality of life, and participation. The effects of the trainings will be analyzed from the collected data and intention-to-treat analysis. Between-groups differences will be measured by two-way ANOVA with repeated measures considering the baseline, post-training, and a 4-week follow-up.

The results of this trial will likely provide valuable new information about the effects of aerobic treadmill training in improving physical activity levels and sedentary behavior, through changes in cardiorespiratory fitness, for individuals following stroke.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The sample size has been calculated considering the physical activity levels measured by the Human Activity Profile (HAP). The effect size has been derived from the study of Teixeira-Salmela et al. 1999, who performed aerobic training in addition to lower limbs resistance training, and home exercises with subjects with chronic stroke. The experimental group (n=6) showed an increase on HAP on average of 20±6.1 points after the intervention, and the control group (n=7) had an average reduction of 1.86±0.19 points. Considering a significance level of 5% and a desired power of 80%, 9 participants per group was found, or 18 participants in total. Assuming an expected dropout rate of 20%, a target of 22 participants in total was set (11 participants per group).

Statistical analyses: A code will be given to each participant. Two independent examiners, blinded to the group allocation, will perform data entry, and verify missing or apparently wrong values. Original paper forms will be kept in a secure place. Electronic files will be available only to the research team. An independent examiner, blinded to the group allocation, will perform the statistical analysis by SPSS (SPSS Inc., Chicago, IL, USA). Descriptive statistics will be performed for all outcome variables. Baseline variables will be compared between groups using independent Student's t-tests, to investigate differences among the groups regarding the clinical-demographical characteristics. If differences between the groups at baseline exist, analysis of covariance will be used to eliminate the influence of extraneous factors. The effects of the interventions will be analyzed from the collected data and the intention-to-treat analysis. Data from the last available assessment will be considered as the values of missed sessions. Between-groups differences will be measured with two-way ANOVA with repeated measures considering the baseline, post-training, and follow-up measures. Level of significance will be set at 0.05 and adjusted for multiple comparisons. Normality and equality of variance will also be analyzed to ensure correct use of parametric data. Study results will be spread regardless of the magnitude and direction of the effects.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

22

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Brasilien
    • Minas Gerais
      • Belo Horizonte, Minas Gerais, Brasilien
        • Universidade Federal De Minas Gerais

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

20 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • ≥ 20years of age;
  • diagnosis of stroke (>6months);
  • sedentary or insufficiently active;
  • have a writing medical permission to participate in the training program.

Exclusion Criteria:

  • cognitive impairment (Mini-Mental Status Examination score: illiterate 13 points; elementary and middle school 18 points; and high-school 26 points; or inability to respond to verbal command);
  • inability to walk independently for at least 10 minutes, with or without walking devices;
  • pain or other disorders precluding their participation.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Aerobic treadmill training

Participants will receive three sessions per week over 12 weeks, in groups of 2-4 participants, by a trained physiotherapist. The duration of the sessions will be 40 minutes (5-10 minutes of warm-up/cool-down and 30 minutes of aerobic treadmill training at 60-80% of heart rate reserve). The training intensity progression will be individualized.

Before and after the training, participants will remain at rest for 10-15 minutes to measure heart rate, blood pressure and peripheral oxygen saturation (SpO2). The heart rate will be measured continuously during training. Participants will be asked to report any discomfort and to not volunteer to participate in other exercise program. Device: treadmill.
Andet: Aerobic treadmill training

Participants will receive three sessions per week over 12 weeks, in groups of 2-4 participants, by a trained physiotherapist. The duration of the sessions will be 40 minutes (5-10 minutes of warm-up/cool-down and 30 minutes of aerobic treadmill training at 60-80% of heart rate reserve). The training intensity progression will be individualized.

Before and after the training, participants will remain at rest for 10-15 minutes to measure heart rate, blood pressure and peripheral oxygen saturation (SpO2). The heart rate will be measured continuously during training. Participants will be asked to report any discomfort and to not volunteer to participate in other exercise program. Device: treadmill.
Sham-komparator: Control (overground walking)
Participants will receive three sessions per week over 12 weeks, in groups of 2-4 participants, by a trained physiotherapist. The duration of the sessions will be 40 minutes (5-10 minutes of warm-up/cool-down and 30 minutes of comfortable walking below 40% of heart rate reserve). Before and after the training, participants will remain at rest for 10-15 minutes to measure heart rate, blood pressure and peripheral oxygen saturation (SpO2). The heart rate will be measured continuously. Participants will be asked to report any discomfort and to not volunteer to participate in other exercise program.
Andet: Control (overground walking)
Participants will receive three sessions per week over 12 weeks, in groups of 2-4 participants, by a trained physiotherapist. The duration of the sessions will be 40 minutes (5-10 minutes of warm-up/cool-down and 30 minutes of comfortable walking below 40% of heart rate reserve). Before and after the exercise, participants will remain at rest for 10-15 minutes to measure heart rate, blood pressure and peripheral oxygen saturation (SpO2). The heart rate will be measured continuously. Participants will be asked to report any discomfort and to not volunteer to participate in other exercise program

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change from baseline in Physical activity levels - multisensor monitor
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Physical activity levels will be assessed by a multisensor monitor (SenseWear®, BodyMedia, Pittsburgh, USA).
At baseline, 12 weeks post-intervention, and at 4-week follow-up
Change from baseline in Physical activity levels - Human Activity Profile
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Physical activity levels will be assessed by Human Activity Profile
At baseline, 12 weeks post-intervention, and at 4-week follow-up
Change from baseline in sedentary behavior - multisensor monitor
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Sedentary behavior will be assessed by a multisensor monitor (SenseWear®, BodyMedia, Pittsburgh, USA).
At baseline, 12 weeks post-intervention, and at 4-week follow-up

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change from baseline in Cardiorespiratory fitness - cardiopulmonary exercise test
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Cardiorespiratory fitness will be assessed by cardiopulmonary exercise test
At baseline, 12 weeks post-intervention, and at 4-week follow-up
Change from baseline in Endurance - six minute walk test
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Endurance will be assessed by six minute walk test
At baseline, 12 weeks post-intervention, and at 4-week follow-up
Change from baseline in Endurance - shuttle walk test
Tidsramme: At baseline,12 weeks post-intervention, and at 4-week follow-up
Endurance will be assessed by shuttle walk test
At baseline,12 weeks post-intervention, and at 4-week follow-up
Change from baseline in Depression - Patient Health Questionnaire (PHQ-2 and PHQ-9)
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Depression will be assessed by Patient Health Questionnaire (PHQ-2 and PHQ-9)
At baseline, 12 weeks post-intervention, and at 4-week follow-up
Change from baseline in Mobility - gait speed
Tidsramme: At baseline,12 weeks post-intervention, and at 4-week follow-up
Mobility will be assessed by gait speed
At baseline,12 weeks post-intervention, and at 4-week follow-up
Change from baseline in Quality of life - Stroke specific quality of life
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Quality of life will be assessed by Stroke specific quality of life
At baseline, 12 weeks post-intervention, and at 4-week follow-up
Change from baseline in Participation - Stroke impact scale
Tidsramme: At baseline, 12 weeks post-intervention, and at 4-week follow-up
Participation will be assessed by (Stroke impact scale)
At baseline, 12 weeks post-intervention, and at 4-week follow-up

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Federal University of Minas Gerais

Efterforskere

  • Ledende efterforsker: Christina Faria, Ph.D., Federal University of Minas Gerais

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

4. december 2017

Primær færdiggørelse (Faktiske)

15. oktober 2018

Studieafslutning (Faktiske)

15. oktober 2018

Datoer for studieregistrering

Først indsendt

6. juni 2016

Først indsendt, der opfyldte QC-kriterier

13. juni 2016

Først opslået (Skøn)

14. juni 2016

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

15. maj 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

13. maj 2019

Sidst verificeret

1. maj 2019

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CAAE:51454115.6.0000.5149

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