OBJECTIVE: To examine the effects of 3 months of aerobic training (AT) followed by coaching on aerobic capacity, strength, and gait speed after subacute stroke. DESIGN: Randomized controlled trial. SETTING: Inpatient rehabilitation center. PARTICIPANTS: Patients (n = 59; mean age +/- SD 65.4 +/- 10.3y; 21 women (36%); Barthel Index <= 50 in 64% of patients) with first stroke and able to cycle at 50 revolutions/min were enrolled in the study 3 to 10 weeks after stroke onset. INTERVENTIONS: Patients were randomly allocated to a 3-month active cycling group (ACG, n = 33) and education, or to a control group (CG, n = 26). Afterward, patients in the ACG were randomly assigned either to a coaching (n = 15) or to a noncoaching group (n = 16) for 9 months. MAIN OUTCOME MEASURES: Aerobic capacity, isometric knee extension strength, and gait ability and speed were measured before and after intervention and during follow-up at 6 and 12 months. RESULTS: A nonsignificant difference was found in workload (Watt-peak) (p = 0.078) between ACG and CG after 3 months. Furthermore, after 3 months of cycling and after 9 months of coaching, all groups showed significant changes over time (p <= 0.027) in peak oxygen consumption, Watt-peak, leg strength, and gait speed. Also, significant changes over time (p < 0.001) were found in the ACG and the CG in patients with walking inability at baseline. CONCLUSIONS: No significant differences between training groups were found over time. Although our study did not have objective exercise data from the training device during follow-up, the 3-month active cycling (AC) program combined with education sessions seemed an applicable method in subacute stroke rehabilitation. New long-term AT interventions should focus on coaching approaches to facilitate training after a supervised AC program.

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