Study Results
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Basic Information
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COMPLETED
NA
4 participants
INTERVENTIONAL
2019-03-27
2020-12-31
Brief Summary
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Adverse cardiovascular events, including stroke, are often due to chronic atherosclerosis, which shows as increased arterial stiffness. Elevated arterial stiffness is prevalent in individuals with cardiovascular disease, is associated with markers of silent cerebrovascular disease and is a new marker for predicting cardiovascular risk. Cardiopulmonary exercise tests (CPETs) are used to assess cardiorespiratory fitness. Novel CPET protocols have emerged for stroke, enabling safe and valid measurements of cardiorespiratory fitness. Cardiovascular exercise, typically performed through moderate-intensity continuous exercise (MICE), can improve function and fitness in individuals living with stroke and lower the risk of recurrent stroke. Recently, high-intensity interval exercise (HIIE) has emerged as a potentially potent stimulus that may also lead to improvements in function and fitness. While HIIE has shown benefits in clinical and non-clinical populations, only a few small, preliminary studies have examined the effects of HIIE in individuals living with stroke, and most have primarily focused on examining the effects of HIIE on function and gait. No study has examined and compared the acute effects of a CPET, MICE and HIIE on arterial stiffness in stroke. This study will (1) examine the acute effects of a single session of this HIIE protocol compared to a CPET and a single session of MICE on arterial stiffness among individuals with chronic stroke, and (2) the feasibility of a high-intensity interval training exercise protocol previously found to be tolerable and effective in attaining high levels of exercise intensity in in these individuals.
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Detailed Description
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While the chronic effects of exercise on arterial stiffness have been examined in stroke, no study has examined the acute effects of a CPET, MICE, or HIIE. Different exercise stimuli may elicit variable short-term influences on arterial stiffness in individuals who have had a stroke, but this has not been previously examined. The feasibility of HIIE for individuals with a broader range of functional abilities after stroke is also not well established.
This study will (1) compare the acute effects of a HIIE session to a CPET and a session of MICE on arterial stiffness and (2) examine the feasibility of a HIIE protocol in individuals with a broad range of abilities after stroke. The investigators anticipate that (1) arterial stiffness will be elevated to a greater degree immediately following HIIE compared to the CPET and MICE, and will remain elevated following 15 minutes post-exercise, and (2) both HIIE and MICE protocols will be safe and feasible for individuals with stroke (no occurrence of adverse events), however the HIIE protocol will allow participants to obtain and be able to sustain a higher level of exercise intensity, and therefore a higher heart rate, compared to MICE. Understanding the time course of changes in arterial stiffness following acute exercise may provide insight into vascular responses of HIIE and thus potential underlying physiological mechanisms of post-stroke exercise.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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Exercise
All participants will perform 3 exercise sessions: one session to assess their cardiorespiratory fitness, one session on moderate-intensity continuous exercise and one session of high-intensity interval exercise
Cardiopulmonary exercise test
Participants will perform a graded cardiopulmonary exercise test to asses their cardiorespiratory fitness. It will also provide a peak exercise stimulus to examine acute changes in arterial stiffness, and to prescribe both moderate intensity continuous exercise and high intensity interval exercise.
Moderate-intensity continuous exercise
Participants will perform a 30-minute session of moderate-intensity continuous exercise.
High-intensity interval exercise
1 week later, participants will perform a 19-minute session of high-intensity interval exercise.
Interventions
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Cardiopulmonary exercise test
Participants will perform a graded cardiopulmonary exercise test to asses their cardiorespiratory fitness. It will also provide a peak exercise stimulus to examine acute changes in arterial stiffness, and to prescribe both moderate intensity continuous exercise and high intensity interval exercise.
Moderate-intensity continuous exercise
Participants will perform a 30-minute session of moderate-intensity continuous exercise.
High-intensity interval exercise
1 week later, participants will perform a 19-minute session of high-intensity interval exercise.
Eligibility Criteria
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Inclusion Criteria
* \>6 months following first-ever, single stroke
* Living in the community (not in an institutional setting)
* Able to walk at least 10 meters (assistive devices permitted)
* Able to follow commands.
Exclusion Criteria
* Significant disability (a score \>2 in the modified Rankin scale)
* Class C or D American Heart Association Risk Scores
* Any contraindications to exercise testing or training as set forth by the American College of Sports Medicine Guidelines for Exercise Testing and Prescription (ACSM, 2014)
* Any other neurological or musculoskeletal condition or co-morbidity that would preclude safe exercise participation
* Pain worsened with exercise
* Any cognitive, communication, or behavioral concerns that could limit safe exercise involvement
40 Years
80 Years
ALL
No
Sponsors
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McMaster University
OTHER
Responsible Party
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Ada Tang
Associate Professor
Principal Investigators
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Ada Tang, PhD
Role: PRINCIPAL_INVESTIGATOR
McMaster University
Locations
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McMaster University
Hamilton, Ontario, Canada
Countries
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References
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Other Identifiers
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3113
Identifier Type: -
Identifier Source: org_study_id
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