Association Between Midlife Cardiorespiratory Fitness and Risk of Stroke

Objectives: to evaluate the feasibility and usability of the Senior Fitness Test (SFT) in persons with acquired brain injury. Methods: A pilot cohort design with a convenience sample of persons with acquired brain injury. Results: Persons with acquired brain injuries [n=47] were younger than their healthy counterparts [n=172] were but performed significantly worse on sit to stand, 6 Minute-Walk-Test (6MWT) and 2.45m up-and-go. This difference was accentuated in the age groups > 60 years of age. Persons with acquired brain injuries, divided into subgroups Traumatic Brain Injury (TBI) [n=12] and Cerebral Insult (CI) [n=35], showed significant differences in leg strength, upper extremity flexibility and walking capacity. Persons with CI were weaker, less flexible in upper and lower extremities, walked shorter distance and were less mobile. CI but not TBI performed significantly worse when compared to healthy elderly persons. Conclusion: This study indicates that SFT is feasible, safe and useful tool for persons with acquired brain injury, to evaluate physical capacity, endurance, strength and flexibility. The sub maximal test was well tolerated and could be performed by all participants irrespective of age or diagnosis. The distribution of test scores indicates responsiveness to change, and no ceiling or floor effects.

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“…The results are in line with other studies indicating poor physical capacity in persons with CI compared to healthy counterparts [17][18].…”

Section: Discussionsupporting

confidence: 92%

Senior fitness test; a useful tool to measure physical fitness in persons with acquired brain injury

Langhammer

Stanghelle

2018

Brain Injury

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“…Physical inactivity and low CRF are well-recognized risk factors for CVD. 14,[63][64][65] Mainly because of the simplicity of data-collection, self-reported PA has been the most commonly studied indicator of CRF.…”

Section: Crf and Risk Of Cvd And Mortalitymentioning

confidence: 99%

The Interaction of Cardiorespiratory Fitness With Obesity and the Obesity Paradox in Cardiovascular Disease

Oktay¹,

Lavie²,

Kokkinos

et al. 2017

Progress in Cardiovascular Diseases

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145

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Overweight and obesity are well-established risk factors for most cardiovascular diseases (CVD), including coronary heart disease (CHD), heart failure (HF), and atrial fibrillation. Despite the strong link between excess adiposity and risk of CVD, growing evidence has demonstrated an obesity paradox in patients with CVD. This phenomenon is characterized by a better prognosis in overweight and mildly obese CVD patients than their leaner counterparts. Moreover, the worst outcomes are often incurred by underweight CVD patients, followed by those of normal weight or severely obese. The obesity paradox is now a well-established phenomenon across different types of CVD, and it occurs regardless of age and ethnicity of patients, and severity of CVD. Physical inactivity and low cardiorespiratory fitness (CRF) have long been recognized as major risk factors for CVD. In contrast, high levels of physical activity (PA) and CRF largely neutralize the adverse effects of excess adiposity and other traditional CVD risk factors, including hypertension, metabolic syndrome, and type-2 diabetes. Higher CRF also results in better CVD outcomes across different BMI groups and significantly alters the obesity paradox in patients with HF and CHD. Prognostic benefits of overweight/obesity tend to be limited to unfit patients with HF and CHD, and the obesity paradox usually disappears with improved levels of CRF. Nevertheless, increased PA and exercise training, to maintain or improve CRF, are effective, safe, and proven strategies for primary and secondary prevention of CVD in all weight groups. In this review, we discuss the current concepts of individual and combined contributions of fatness and fitness to CVD risk and prognosis. We then examine the influence of fitness on the obesity paradox in individuals with CVD.

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“…These benefits were not enjoyed by the TST group. The AEX + TST also improved their cardiorespiratory fitness more than the TST group, which is an important risk factor in the prevention of stroke (Hussain et al, ; Pandey et al, ). These findings support the merit of including aerobic exercise as part of a comprehensive stroke rehabilitation intervention (Collins, Clifton, Wijck, & Mead, ; Gezer, Karaahmet, Gurcay, Dulgeroglu, & Cakci, ).…”

Section: Discussionmentioning

confidence: 99%

Aerobic exercise and consecutive task‐specific training (AExaCTT) for upper limb recovery after stroke: A randomized controlled pilot study

Valkenborghs

Vliet

Nilsson

et al. 2019

Physiotherapy Res Intl

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Objective This study examined the feasibility of a parallel‐group assessor‐blinded randomized controlled trial investigating whether task‐specific training preceded by aerobic exercise (AEX + TST) improves upper limb function more than task‐specific training (TST) alone. Methods People with upper limb motor dysfunction after stroke were allocated to TST or AEX + TST. Both groups were prescribed 60 hr of TST over 10 weeks (3 × 1‐hr sessions with a therapist per week and 3 × 1 hr of home‐based self‐practice per week). The AEX + TST group performed 30 minutes of aerobic exercise immediately prior to the 1 hr of TST with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events were recorded. Clinical measures were performed prerandomization at baseline, on completion of the intervention, and at 1‐ and 6‐month follow‐up. Results Fifty‐nine persons after stroke were screened, 42 met the eligibility criteria, and 20 (11 male; mean [SD] age: 55.4 [16.0] years; time since stroke: 71.7 [91.2] months) were recruited over 17 months. The mean Wolf Motor Function Test Functional Ability Score at baseline was 27.4 (max = 75) and the mean Action Research Arm Test score was 11.2 (max = 57). Nine were randomized to AEX + TST and 11 to TST. There were no adverse events, but there was one drop out. Retention at 1‐ and 6‐month follow‐up was 80% and 85%, respectively. Attendance was 93% (6) for the AEX + TST group, and 89% (9) for the TST group. AEX + TST was perceived as acceptable (100%) and beneficial (87.5%). Exertional fatigue (visual analogue scale) prior to TST was worse in the AEX + TST group (3.5 [0.7] out of 10) than the TST group (1.7 [1.4] out of 10). The TST group performed 31% more repetitions per session than the AEX + TST group. Conclusion A subsequent Phase III study is feasible, but modifications to eligibility criteria, outcome measures, and intervention delivery are recommended.

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Association Between Midlife Cardiorespiratory Fitness and Risk of Stroke

Cited by 57 publications

References 51 publications

Senior fitness test; a useful tool to measure physical fitness in persons with acquired brain injury

Senior fitness test; a useful tool to measure physical fitness in persons with acquired brain injury

The Interaction of Cardiorespiratory Fitness With Obesity and the Obesity Paradox in Cardiovascular Disease

Aerobic exercise and consecutive task‐specific training (AExaCTT) for upper limb recovery after stroke: A randomized controlled pilot study

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