Improvement of the motor and functional capacity of post-cerebrovascular accident hemiplegics by exercise retraining combined with a varied exercises program

Year 2023, , 85 - 90, 30.06.2023

Godefroid Kusuayi , Carel Busano Nduakulu Siloé Ntumba Tshıyamba Constant Nkıama

https://doi.org/10.31459/turkjkin.1240330

Abstract

The study aimed to investigate the effect of exercise retraining combined with a program of varied physical exercises on heart rate, training intensity, aerobic capacity, lower limb strength, and body composition of hemiplegic patient’s post-cerebrovascular accident. This was a 12-week follow-up study, of 30 post-stroke hemiplegic patients aged 18 years and over, who were subjected to an effort retraining program, consisting of walking on a treadmill at a progressive speed of 2.7 to 6 km per hour and a slope of 5 to 12% combined with various transfer exercises, going up and down stairs, on an ergometric bike, balance and limb strengthening thighs, Abdo and Buttocks, lasting 60 minutes per session, 3 times a week and from 40 to 75% progressive of the Maximum Heart Rate. We used the paired Student's t-test to compare continuous variables before and after the programs. A significant increase was obtained in 12 weeks of intervention for most of the parameters: +12 (37 vs 49); p < 0.001 for balance, +1.4 meters per second (1.39 vs 2.79). p < 0.001 for walking speed, +4 degrees (11 vs 15); p < 0.001 for step angle, +32 steps per minute (37 vs 69); p < 0.001 for walking cadence; +213 meters (143 vs. 356); p < 0.001 for the distance covered in six minutes, +3 ml/min/Kg (29 vs 32); p < 0.001 for maximum oxygen consumption and +12% (22 vs 34); p < 0.001 for lean body mass. On the other hand, the time of the Time up and go test, of the walk on the descent and ascent, and the fat mass, was significantly reduced: -14 seconds (55 vs 41), p < 0.003; -16 minutes (67 vs. 51); p < 0.001 and -16 minutes (59 vs 43); p < 0.001 and - 5% (41 vs 36); p<0.001. The exercise training program combined with various physical exercises improves the maximum oxygen consumption of post-stroke hemiplegic patients. The combination of an exercise training approach based on functional and motor improvement should make it possible to optimize post-stroke rehabilitation strategies.

Keywords

Motor and functional capacity, hemiplegia, exercise retraining, varied physical exercises

References

• Adoukonou, T. A., Vallat, J-M., Joubert, J., Macian, F., Kabore, R., Magy, L., Houinato, D., & Preux, P.-M. (2010). Prise en charge des accidents vasculaires cérébraux en Afrique subsaharienne. Rev Neurol, 166(11), 882-893.
• Barbeau, M., Lord, S. E., Rochester, L., Weatherall, M., McPherson, K. M., & McNaughton, H. K. (2006). The effect of environment and task on gait parameters after stroke: a randomized comparison of measurement conditions. Arch Phys Med Rehabil, 87(7), 967-973.
• Bohannon, R. W. (1987). Gait performance of hemiparetic stroke patients: selected variables. Arch Phys Med Rehabil, 68(11), 777-781.
• Bourgeais, A. L., Guay, V., Laraudie, L., Marsal, C., & Thevenin-Lemoine, E. (2009). Information booklet and self-rehabilitation program following a stroke for caregivers intended for hemiplegic people. HPST Law, 21, L.1161-1-L.
• Chaudhuri, A., & Behan, P. O. (2004). Fatigue in neurological disorders. Lancet, 363(9413), 978‑988.
• Courbon, A., Calmels, P., Roche, F., Ramas, J., & Fayolle-Minon, I. (2006). Relationship between walking capacity and maximal exercise capacity, strength and motor deficiency in adult hemiplegic stroke patients. Ann Phys Med Rehabil, 49(8), 614-620.
• Donovan, K., Lord, S. E., McNaughton, H. K., & Weatherall, M. (2008). Mobility beyond the clinic: the effect of environment on gait and its measurement in community-ambulant stroke survivors. Clin Rehabil, 22(6), 556-563.
• Gallien, P., Adrien, S., Petrilli, S., Durufle, A., Robineau, S., Kerdoncuff, V., … Nicolas, B. (2005). Maintien à domicile et qualité de vie à distance d’un accident vasculaire cerebral. Ann Phys Med Rehabil, 48(5), 225-230.
• Harari, D., Norton, C., Lockwood, L., & Swift, C. (2004). Treatment of constipation and fecal incontinence in stroke patients randomized controlled trial. Stroke, 35(11), 2549‑2555.
• Heyward, V. (2010). Advanced fitness assessment and exercise prescription (6th edition). US: Human Kinetics.
• Johnston, S. C., Mendis, S., & Mathers, C. D. (2009). Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol, 8(4), 345-354.
• Karvonen, M. J., Kentala, E., & Mustala, O. (1957). The effects of training on heart rate: a longitudinal study. Ann Med Exper Fenn, 35, 307–315.
• Kessomtini, W. (2015). Les douleurs de l’hémiplégique vasculaire du diagnostic à la prise en charge thérapeutique. Dl. Eval Diag Trt, 16(1), 32-37.
• Kim, A. S., & Johnston, S. C. (2011). Global variation in the relative burden of stroke and ischemic heart disease. Circulation, 124(3), 314-323.
• Klit, H., Finnerup, N. B., & Jensen, T. S. (2009). Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet Neuro, 8(9), 857-868.
• Kusuayi, M. G., Nkiama, E. C., Kiana, N. N., Bongo, N. J. & Kayembe, N. J. M. (2018b). Improvement of the cardiopulmonary capacity of patients with chronic obstructive pulmonary disease of Kinshasa by training of aerobic endurance and resistance. Turk J Kinesiol, 4(4), 149-154.
• Kusuayi, M., Ekisawa, C. N., Delecluse, C., Bompeka, F. L., & Nkodila Natuhoyila, A. (2018a). Evaluation de la prévalence de l’hypertension artérielle de l’adulte en milieu du travail à Kinshasa, République Démocratique du Congo. Science & Sports, 33(4), 213-220.
• Monod-Broca P. (2001). Paul Broca: 1824-1880 [Paul Broca: 1824-1880]. Ann Chir, 126(8), 801–807. O'Donnell, M. J., Chin, S. L., Rangarajan, S., Xavier, D., Liu, L., Zhang, H., … INTERSTROKE investigators (2016). Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): A case-control study. Lancet (London, England), 388(10046), 761–775.
• Petrilli, S., Durufle, A., Nicolas, B., Pinel, J. F., Kerdoncuff, V., Gallien, P. (2002). Hémiplégie vasculaire et retour à domicile. Ann Readapt Med Phys, 45(2), 69‑76.
• Sibley, K. M., Tang, A., Patterson, K. K., Brooks, D., McIlroy, W. E. (2009). Changes in spatiotemporal gait variables over time during a test of functional capacity after stroke. J Neuroeng Rehabil, 6, 27.
• Tanaka, H., Monahan, K. D., & Seals, D. R. 82001). Age-predicted maximal heart rate revisited. J Am Coll Cardiol, 37 (1) 153–156.
• Toledano, K., Mann, G., Hankey, G. J., Cameron, D. (1999). Swallowing function after stroke prognosis and prognostic factors at 6 months. Stroke, 30(4), 744‑748.
• Truelsen, T. (2010). Stroke incidence studies in Africa. The Lancet Neuro, 9(8), 755–757.
• Walker, R. W., Jusabani, A., Aris, E., Gray, W. K., Mugusi, F., Swai, M., Alberti, K. G., & Unwin, N. (2012). Correlates of short- and long-term case fatality within an incident stroke population in Tanzania. S Afr Med J, 103(2), 107–112.