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Pulsfrequenzgesteuertes ausdauertraining bei patienten nach schlaganfall: randomisierte kontrollierte pilotstudie zur herzratenvariabilitat (Pulse frequency controlled endurance training in patients after stroke randomised controlled pilot study on heart rate variability) [German]
Glaser M, Ring-Dimitriou S, Bancher C, Pinter M
Physioscience 2016 Mar;12(1):11-16
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Along with the characteristic neurological deficits in patients after stroke often cardiovascular functional capacity and autonomic (vegetative) nervous system's constraints become apparent. Moderate endurance training improves cardiovascular capacity and heart rate variability (HRV) in healthy, elderly and cardiac subjects. In patients after stroke it has, however, not yet been investigated sufficiently. A high HRV can be considered as an indicator of a well-balanced autonomic nervous system. OBJECTIVE: This randomised controlled pilot study with patient-blinded design investigated whether a three week's pulse frequency controlled endurance can improve HRV in patients after stroke. METHOD: Patients after subacute stroke were selected according to the inclusion criteria and randomised into 2 exercise groups (group A: pulse frequency controlled, group B: no intensity modulation). During the intervention period all subjects performed ergometer training 4 times per week for 20 to 30 minutes. The autonomic nervous system was investigated using the 24 hours' HRV measurement and the functional walking ability was assessed using the 6-minutes walk test (6-MWT). RESULTS: There were no statistically significant group differences to be found for primary (HRV) and secondary (6 MWT) outcomes. The time and frequency ranges of HRV did not change sufficiently in neither group, in order to attain the significance level of p < 0.05. In both groups the functional walking ability during 6 MWT improved significantly (group A: 21.5%, p = 0.002); group B. 14.4%, p = 0.04). In group A the ergometer performance grew significantly by 28.1% (p = 0.02) and in group B by 13.9% (p = 0.4). CONCLUSIONS: In patients after stroke no HRV improvements were to be found during the three weeks' investigation period using individual pulse frequency controlled endurance training. However, in patients after subacute stroke physiotherapy accompanied by endurance training improved significantly the functional walking ability.

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