An 8-week Forced-rate Aerobic Cycling Program Improves Cardiorespiratory Fitness in Persons With Chronic Stroke: A Randomized Controlled Trial.

All participants were ambulatory (could walk at least 20 meters) and community-dwelling, so the findings may not apply to people with more severe impairment or those in acute inpatient rehabilitation. The study was conducted at a single center with 50 people in the final analysis. Six of the 56 who completed the intervention did not complete the end-of-treatment cardiopulmonary test, for reasons including injury, illness, the 2020 pandemic shutdown, and unwillingness to undergo pre-procedural testing. The authors note that people who were already receptive to an exercise program were more likely to enroll, which may inflate the results. Stroke lesion location and size were not included in the statistical models. The motorized cycle used was custom-engineered for the study, though the authors note two commercial options exist at roughly $4,000-6,000.

Funded by the National Institutes of Health (K01HD092556). Dr. Alberts declares a conflict of interest related to intellectual property in the motorized cycle used in the trial. The other authors report no conflicts.

Do not assume this protocol will work for your non-ambulatory or acute stroke patients. Every participant in this study could already walk at least 20 meters with no more than contact-guard assistance, and all were at least 6 months post-stroke. The authors themselves say they are uncertain whether lower-functioning individuals would tolerate the program or achieve comparable gains.