MODERADE TO VIGOROUS INTENSITY MULTIMODAL CIRCUIT TRAINING EFFICACY TO INCREASE STEPS PER DAY IN STROKE SURVIVORS: RANDOMIZED CLINICAL TRIAL.

• Grant number: 23/00506-3
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: June 01, 2023
• Status: Discontinued
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Thiago Luiz de Russo
• Grantee: Ana Flávia Silveira
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Associated scholarship(s): 24/18811-0 - An exploration of knowledge and skills in monitoring exercise intensity during stroke rehabilitation: a qualitative study, BE.EP.DR

Abstract

Introduction: Post-stroke individuals follow a worried pattern of physical inactivity, as they walk less than necessary and spend long periods of the day seated, increasing the risk of developing numerous health problems, such as new stroke episodes. Multimodal circuit training has been recommended by guidelines to improve mobility in this population. This type of exercise provides strength, flexibility and balance stimuli, which are fundamental for the sensorimotor recovery of people who suffered a stroke. Furthermore, if organized to emphasize and sustain the intensity, based on heart rate (HR) level, it can be considered a great aerobic exercise. Currently, the effectiveness of multimodal circuit training, with moderate and high HR intensities, on the real-world walking ability of people who have had a stroke is unknown. In this sense, investigating the number of steps/day, measured by activity monitors, could complement the knowledge about the physical components of these people's social participation. Objective: To evaluate the effectiveness of a multimodal circuit exercise protocol in order to increase the number of steps in people affected by stroke. Methodology: This is a randomized clinical trial. A total of 48 individuals with at least 6 months post-stroke, who are able to walk independently, will be enrolled in this trial. They will be randomized into 2 groups that will receive physical exercise protocols 3x a week over 12 weeks. The intervention group will receive a progressive multimodal circuit, with moderate to high intensity (HRtarget of 50-80% of HRreserve); and the control group will receive light intensity balance training sessions (HRtarget <40%). The evaluations will be carried out pre- and post-intervention, up to one week and with a follow up of 3 months. The main outcome will be the number of steps/day and the secondary ones will be time spent in physical inactivity (0 steps/minute), quality of life, sensorimotor impairment, functional balance, walking speed, muscle strength, self-perception of the level of assistance, performance quality and walking confidence; walking endurance and fitness. The intragroup and intergroup comparisons, as well as pos-intervention and follow-up comparisons, will be calculated by the Two Way ANOVA, or the Friedman analysis (considering the alpha adjusted by Bonferroni adjustment). The significance level adopted will be 5% (p-value <0,05). The software statistical packages for the social sciences version 22 will be used to calculate it.

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

SILVEIRA, ANA FLAVIA; SANTOS, MARCELLA BARRETO; COLLANGE, NELCI ZANON; HAYASHI, CINTYA YUKIE; VILELA, GUSTAVO HENRIQUE FRIGIERI; DE ALMEIDA, SAMANTHA LONGHI SIMOES; DE ANDRADE, JOAO BRAINER CLARES; ROJAS, SALOMON; DE MORAES, FABIANO MOULIN; VEIGA, VIVIANE CORDEIRO; et al. Intracranial compliance in patients with COVID-19: a multicenter observational study. Arquivos de Neuro-Psiquiatria, v. 82, n. 09, p. 8-pg., 2024-09-01. (23/00506-3)

OLIVEIRA, SIMONE GARCIA; RIBEIRO, JEAN ALEX MATOS; SILVA, ERIKA SHIRLEY MOREIRA; ULIAM, NICOLY RIBEIRO; SILVEIRA, ANA FLAVIA; ARAUJO, PALOMA NEPOMUCENO; CAMARGO, ANA ISABELA; URRUCHIA, VITORIA REGINA ROCHA; NOGUEIRA, SAMUEL LOURENCO; RUSSO, THIAGO LUIZ. Interventions to Change Movement Behaviors After Stroke: A Systematic Review and Meta-analysis. ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, v. 105, n. 2, p. 30-pg., 2024-02-01. (17/25185-4, 17/13655-6, 23/00506-3)