Clinical Trials Logo

Clinical Trial Summary

There is an urgent need to reduce the impact of stroke by promoting optimal rehabilitation strategies that decrease the risk of stroke. Improving cardiovascular health following a stroke is a key rehabilitation strategy that has the potential to reduce the risk of a recurrent event. 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.


Clinical Trial Description

Stroke is the leading cause of adult disability and the fourth leading cause of death in Canada, with an annual cost to the economy of $3.6 billion. There is an urgent need to reduce the impact of stroke by promoting optimal rehabilitation strategies that decrease the risk of stroke. Improving cardiovascular health following a stroke is a key rehabilitation strategy that has the potential to reduce the risk of a recurrent event. Adverse cardiovascular events, including stroke, are often due to chronic atherosclerosis. Amplified arterial stiffness is a sign of atherosclerosis which increases arterial wall stress and reduces coronary perfusion. 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 the gold standard for assessing cardiorespiratory fitness. In stroke, impairments in physical function may be present and limit individuals' ability to perform a CPET on traditional modes such as a cycle ergometer or treadmill. Thus, novel CPET protocols have been developed to allow individuals with stroke perform a fitness test safely and effectively. 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. HIIE combines short bursts of high-intensity cardiovascular exercise with periods of rest or recovery, and allows individuals to achieve higher intensities of cardiovascular exercise that do not need to be maintained for a long period of time like MICE. In this way, HIIE has the potential to be an additional exercise strategy to enhance cardiovascular health post-stroke. 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. 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. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03570216
Study type Interventional
Source McMaster University
Contact
Status Completed
Phase N/A
Start date March 27, 2019
Completion date December 31, 2020

See also
  Status Clinical Trial Phase
Completed NCT05008822 - Effect of Motor Imaginary Training on Upper Limb Functions in Stroke N/A
Recruiting NCT04607070 - Ischemic Strokes While on NOAC - How Compliance Matters
Recruiting NCT05745051 - The Safety and Effectiveness of CVA-FLOW Software Device for Acute Ischemic Stroke N/A
Completed NCT05414539 - OptiCogs: A Multicomponent Intervention to Rehabilitate Cognitive Impairment in People Post-stroke N/A
Completed NCT04777955 - The Effects of Core Stabilization Exercises With Swisball in Stroke Patients N/A
Recruiting NCT03723382 - Stroke in Egyptian Clinical REgisTry
Completed NCT04306120 - Effects of Thermal Stimulation on Motor Recovery and Neuromuscular Property of Lower Extremity in Stroke N/A
Completed NCT02743520 - Arrhythmia Detection In Obstructive Sleep Apnea (ADIOS) N/A
Completed NCT03466372 - Innovative Gait Biofeedback Strategies for Stroke Rehabilitation N/A
Not yet recruiting NCT04523649 - Home-Based SolUtion for Remote Atrial Fibrillation Screening to PrevenT RecUrrence StrOke (HUA-TUO AF Trial) N/A
Completed NCT03194282 - Effects of the Insole on Balance Capacity in Chronic Stroke N/A
Recruiting NCT05289947 - MLC1501 Study Assessing Efficacy in Post STrOke Subjects With mOtor Deficits Phase 2
Completed NCT05058586 - The Effects of Aerobic Exercise Training on Cardiorespiratory Fitness in Stroke Patients N/A
Not yet recruiting NCT05046106 - MLC1501 Study Assessing Efficacy in STROke Recovery Phase 2/Phase 3
Completed NCT03845595 - Cortical Excitability Sequential Changes in Response to Transcranial Magnetic Stimulation Post Stroke N/A
Recruiting NCT04699409 - The Comparison of Educational Effectiveness Between FAST and STROKE 112 in Yunlin Community N/A
Not yet recruiting NCT04138407 - Effects of Seated Tai Chi on Recovery Among Stroke Survivors N/A
Completed NCT04096248 - CT (Computerized Tomography) for Late EndovasculAr Reperfusion
Recruiting NCT06303050 - Additional Effects of Mental Imagery Along With Task Oriented Training on Kinesiophobia in Patients With Stroke N/A
Recruiting NCT04038697 - Ischemic Conditioning Improves Walking Function Post Stroke N/A