Effectiveness of Active Cycling in Subacute Stroke Rehabilitation: A Randomized Controlled Trial

Christel Vanroy, Hilde Feys, Anke Swinnen, Yves Vanlandewijck, Steven Truijen, Dirk Vissers, Marc Michielsen, Kristien Wouters, Patrick Cras

To examine the effects of 3-month aerobic training (AT) followed by coaching on aerobic capacity, strength and gait speed after subacute stroke. Randomized controlled trial SETTING: Inpatient rehabilitation center PARTICIPANTS: Patients (N=59; mean age= 65.4±10.3; 21 women (36%); Barthel Index≤50= 64%) with first stroke and able to cycle at 50 revolutions/minute enrolled in the study 3-10 weeks after stroke onset. Patients were randomly allocated to a 3-month cycling group (ACG, n=33) and education or to a control group (CG, n=26). Afterwards, ACG was randomized into a coaching (n=15) versus non-coaching group (n=16) for nine months. Aerobic capacity, isometric knee extension strength and gait ability and speed were measured before and after intervention and during follow-up at six and 12 months. A non-significant difference was found in workload (Wattpeak) (p=.078) between ACG and CG after three months. Furthermore after 3-month cycling and after nine-month coaching, all groups showed significant changes over time (p≤.027) in peak oxygen consumption (VO2peak), Wattpeak, leg strength and gait speed. Also significant changes over time (p<.001) were found in ACG and CG in patients with walking inability at baseline. No significant differences between training groups were found over time. Although our study missed objective exercise data from the training device during follow-up, the 3-month AC program combined with education sessions seemed an applicable method in subacute stroke. New long-term AT interventions should focus on coaching approaches to facilitate training after a supervised AC program.