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Valkenborghs SR, Visser MM, Dunn A, Erickson KI, Nilsson M, Callister R, van Vliet P. AExaCTT - Aerobic Exercise and Consecutive Task-specific Training for the upper limb after stroke: Protocol for a randomised controlled pilot study. Contemp Clin Trials Commun 2017; 7:179-185. [PMID: 29696183 PMCID: PMC5898578 DOI: 10.1016/j.conctc.2017.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 07/02/2017] [Accepted: 07/20/2017] [Indexed: 11/23/2022] Open
Abstract
Motor function may be enhanced if aerobic exercise is paired with motor training. One potential mechanism is that aerobic exercise increases levels of brain-derived neurotrophic factor (BDNF), which is important in neuroplasticity and involved in motor learning and motor memory consolidation. This study will examine the feasibility of a parallel-group assessor-blinded randomised controlled trial investigating whether task-specific training preceded by aerobic exercise improves upper limb function more than task-specific training alone, and determine the effect size of changes in primary outcome measures. People with upper limb motor dysfunction after stroke will be allocated to either task-specific training or aerobic exercise and consecutive task-specific training. Both groups will perform 60 hours of task-specific training over 10 weeks, comprised of 3 × 1 hour sessions per week with a therapist and 3 × 1 hours of home-based self-practice per week. The combined intervention group will also perform 30 minutes of aerobic exercise (70-85%HRmax) immediately prior to the 1 hour of task-specific training with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events will be recorded. Clinical outcome measures will be performed pre-randomisation at baseline, at completion of the training program, and at 1 and 6 months follow-up. Primary clinical outcome measures will be the Action Research Arm Test (ARAT) and the Wolf Motor Function Test (WMFT). If aerobic exercise prior to task-specific training is acceptable, and a future phase 3 randomised controlled trial seems feasible, it should be pursued to determine the efficacy of this combined intervention for people after stroke.
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Key Words
- 6MWT, Six Minute Walk Test
- ARAT, Action Research Arm Test
- Aerobic exercise
- BDNF, brain-derived neurotrophic factor
- CERT, Consensus on Exercise Reporting Template
- CM, centimetre
- CONSORT, Consolidated Standards of Reporting Trials
- ECG, electrocardiography
- ELISA, enzyme-linked immunosorbent assay
- FAS, Fatigue Assessment Scale
- GP, general practitioner
- HRmax, age-predicted maximal heart rate maximum
- HRpeak, peak heart rate
- IPAQ, International Physical Activity Questionnaire
- MAL, Motor Activity Log
- MRI, magnetic resonance imaging
- MS, Microsoft
- Motor function
- NAA, N-acetyl Aspartate
- PD, Peak Deceleration
- PV, Peak Velocity
- REDCap, Research Electronic Data Capture
- RPE, rating of perceived exertion
- RPM, revolutions per minute
- SIS, Stroke Impact Scale
- Stroke
- Task-specific training
- VO2, oxygen uptake
- VO2peak, peak oxygen uptake
- WMFT, Wolf Motor Function Test
- m/s, millimetres per second
- mL.kg−1.min−1, millilitres per kilogram per minute
- reps, repetitions
- s, seconds
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Affiliation(s)
- Sarah R. Valkenborghs
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Milanka M. Visser
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Ashlee Dunn
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Michael Nilsson
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Paulette van Vliet
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
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