Cardiovascular fitness is improved post-stroke with upper-limb Wii-based Movement Therapy but not dose-matched constraint therapy. Issue 3 (2nd April 2016)

• Record Type: Journal Article
• Authors: Trinh, Terry; Scheuer, Sarah E.; Thompson-Butel, Angelica G.; Shiner, Christine T.; McNulty, Penelope A.
• Is Part Of: Topics in stroke rehabilitation. Volume 23:Issue 3(2016)
• Page Start: 208
• Page End: 216
• Publication Date: 2016-04-02
• Subjects: Rehabilitation -- Heart rate -- Aerobic exercise -- Stroke -- Upper extremity -- Heart rate recovery -- Cardiac stress response; Cerebrovascular disease -- Patients -- Rehabilitation -- Periodicals; Cerebrovascular disease -- Periodicals; 616.810305
• DOI: 10.1080/10749357.2016.1138672
• Languages: English
• ISSNs: 1074-9357

Abstract

Abstract : Introduction: Post-stroke cardiovascular fitness is typically half that of healthy age-matched people. Cardiovascular deconditioning is a risk factor for recurrent stroke that may be overlooked during routine rehabilitation. This study investigated the cardiovascular responses of two upper limb rehabilitation protocols. Methods: Forty-six stroke patients completed a dose-matched program of Wii-based Movement Therapy (WMT) or modified Constraint-induced Movement Therapy (mCIMT). Heart rate and stepping were recorded during early (day 2)- and late (day 12–14)-therapy. Pre- and post-therapy motor assessments included the Wolf Motor Function Test and 6-min walk. Results: Upper limb motor function improved for both groups after therapy (WMT p = 0.003, mCIMT p = 0.04). Relative peak heart rate increased from early- to late-therapy WMT by 33% ( p < 0.001) and heart rate recovery (HRR) time was 40% faster ( p = 0.04). Peak heart rate was higher and HRR faster during mCIMT than WMT, but neither measure changed during mCIMT. Stepping increased by 88% during Wii-tennis ( p < 0.001) and 21% during Wii-boxing ( p = 0.045) while mCIMT activities were predominantly sedentary. Six-min walk distances increased by 8% ( p = 0.001) and 4% ( p = 0.02) for WMT and mCIMT, respectively. Discussion: Cardiovascular benefits were evident after WMT as both a cardiovascular challenge and improved cardiovascular fitness. The peak heart rate gradient across WMT activities suggests this therapy can be further individualized to address cardiovascular needs. The mCIMT data suggest a cardiovascular stress response. Conclusions: This is the first study to demonstrate a cardiovascular benefit during specifically targeted upper limb rehabilitation. Thus, WMT not only improves upper limb motor function but also improves cardiovascular fitness.