Effect of aerobic exercise prior to modified constraint-induced movement therapy outcomes in individuals with chronic hemiparesis: a study protocol for a randomized clinical trial

Author(s)

Moreira da Silva, Erika Shirley ^[1] ; Santos, Gabriela Lopes ^{[1, 2]} ; Catai, Aparecida Maria ^[3] ; Borstad, Alexandra ^[4] ; Duarte Furtado, Natalia Pereira ^[1] ; Verzola Aniceto, Isabela Arruda ^[5] ; Russo, Thiago Luiz ^[1]

Affiliation

^[1] Fed Univ Sao Carlos UFSCar, Lab Neurol Physiotherapy Res, Dept Physiotherapy, Rodovia Washington Luis, Km 235, BR-13565905 Sao Carlos, SP - Brazil

^[2] Aparecida Goiania, Fac Alfredo Nasse, Hlth Sci Inst, Goiania, Go - Brazil

^[3] Fed Univ Sao Carlos UFSCar, Cardiovasc Phys Therapy Lab, Dept Physiotherapy, Sao Carlos, SP - Brazil

^[4] EUA, Coll St Scholast, Duluth, MN - USA

^[5] Fed Univ Sao Carlos UFSCar, Hlth Unit, Sao Carlos, SP - Brazil

• Document type: Journal article
• Source: BMC Neurology; v. 19, n. 1 AUG 15 2019.
• Web of Science Citations: 1

Abstract

Background Recovery of upper limb function in individuals after a stroke remains challenging. Modified constraint-induced movement therapy (m-CIMT) has strong evidence for increasing the use and recovery of sensorimotor function of the paretic upper limb. Recent studies have shown that priming with aerobic exercise prior to task-specific training potentiates upper limb recovery in individuals with stroke. This protocol describes a randomized clinical trial designed to determine whether priming with moderate-high intensity aerobic exercise prior to m-CIMT will improve the manual dexterity of the paretic upper limb in individuals with chronic hemiparesis. Methods Sixty-two individuals with chronic hemiparesis will be randomized into two groups: Aerobic exercise + m-CIMT or Stretching + m-CIMT. m-CIMT includes 1) restraint of the nonparetic upper limb for 90% of waking hours, 2) intensive task-oriented training of the paretic upper limb for 3 h/day for 10 days and 3) behavior interventions for improving treatment adherence. Aerobic exercise will be conducted on a stationary bicycle at intervals of moderate to high intensity. Participants will be evaluated at baseline, 3, 30, and 90 days postintervention by the following instruments: Motor Activity Log, Nottingham Sensory Assessment, Wolf Motor Function Test, Box and Block Test, Nine-Hole Peg Test, Stroke Specific Quality of Life Scale and three-dimensional kinematics. The data will be tested for normality and homogeneity. Parametric data will be analyzed by two-way ANOVA with repeated measures and Bonferroni's adjustment. For nonparametric data, the Friedman test followed by the Wilcoxon test with Bonferroni's adjustment will be used to compare the ratings for each group. To compare the groups in each assessment, the Mann-Whitney test will be used. Discussion This study will provide valuable information about the effect of motor priming for fine upper limb skill improvement in people with chronic poststroke hemiparesis, bringing new evidence about the association of two therapies commonly used in clinical practice. (AU)

• FAPESP's process: 17/13655-6 - Sedentary behaviour and arterial dysfunction in chronic post-stroke subjects
• Grantee: Thiago Luiz de Russo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 17/25185-4 - The effect of the aerobic exercise associated to the modified constraint-induced movement therapy in chronic hemiparetic individuals: a randomized clinical trial
• Grantee: Erika Shirley Moreira da Silva
• Support Opportunities: Scholarships in Brazil - Doctorate