Early post-stroke physical conditioning in hemiplegic patients: A preliminary study

To establish the value of an early post-stroke evaluation of cardiorespiratory fitness in hemiparetic patients using a one-leg cycling exercise test and to analyze the impact of an adapted physical activity programme 12 weeks after the stroke.

Eighteen hemiparetic stroke patients participated in the study. The subjects were randomly assigned to one of two groups: the control group (CG) underwent 4 weeks of conventional rehabilitation, whereas the training group (TG) performed additional physical exercises. The initial evaluation (T1) was carried out after 1 week of exercise and the final evaluation (T2) was performed after 28 days. Both evaluations consisted of maximal graded tests performed with the valid leg, followed by completion of a questionnaire on personal autonomy in activities of daily living (ADL).

In the CG group, we recorded a 4 to 8% increase in peak oxygen uptake (VO₂ peak). There was no significant increase in peak power output (Wpeak). However, the TG displayed significantly (P<0.05) greater peak values than those recorded on study entry (Wpeak: +30%, VO₂ peak: +20%). The TG showed a statistically significant improvement in the Barthel and Katz ADL scale scores, whereas the pre- and post-rehabilitation values did not differ significantly in the CG. However, there was no correlation between the Barthel/Katz scale scores and Wpeak.

Evaluation of cardiorespiratory fitness by using the valid leg seems to be feasible in hemiplegic patients 1 month post-stroke. Early post-stroke physical training appears to be needed to limit the negative effects of functional hypoactivity.