Task Practice With and Without Aerobic Exercise Improves Health-related Quality of Life and Social Participation Post-stroke: A Randomized Clinical Trial.
Susan M Linder, Andrea Bischof-Bockbrader, Ozlenen Eylul Ince Hocaoglu and 6 others
PMID 40401784WHAT IT FOUND
Adding aerobic cycling to upper-extremity task practice did not improve quality of life, mood, or participation more than task practice alone in 60 people with chronic stroke.
Both groups improved and kept those gains at 12 months.
Key findings
01No significant group differences were found in any Stroke Impact Scale domain. Both groups improved significantly from baseline to end of treatment, 6 months, and 12 months in physical problems, feelings, ADLs, mobility, hand use, meaningful activities, and overall recovery.
02The only significant group difference was the proportion meeting the minimal clinically important difference for mobility at 12 months: 55.6% in the task-practice-only group versus 23.8% in the cycling-plus-task-practice group (P = .042).
03Depressive symptoms improved from baseline to 6 months in both groups with no group effect. The proportion at risk for clinical depression decreased from 29.6% to 20.7% in the cycling group and from 34.6% to 33.3% in the task-practice-only group at end of treatment, then to 20.0% and 10.5% respectively at 12 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
All participants were community-dwelling with relatively high quality of life at baseline, so the results may not apply to people with more severe impairment or to those in the acute or subacute phase. The MCID was not met by a majority of participants, even though group-level changes were statistically significant. Only patient-reported outcomes were collected; there were no clinical measures of participation, mood, or cognitive function. Three participants declined the questionnaires, and two in the cycling group completed fewer than 24 sessions because of the pandemic shutdown. Randomization did not balance stroke chronicity between groups, though a sensitivity analysis controlling for it did not change the results.
Declared interests
Dr. Alberts declares a conflict of interest related to intellectual property for the motorized cycle used in the trial. The study was supported by U.S. government funding (P.H.S.).
The easy way to misread this
Do not read the title as evidence that adding aerobic cycling to task practice improves quality of life more than task practice alone. The primary outcome showed no group difference in any SIS domain, and the only significant group difference (mobility at 12 months) favored the task-practice-only group, not the exercise group.
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