Benefits of Supplementary Fast Walking to Strength Exercise Program for Cardiopulmonary Fitness in Chronic Stroke Patients

PURPOSE: This study investigated whether a supplementary fast walking before starting strength training program may induce an additional fitness enhancement in chronic stroke patients. METHODS: A total of 24 hemiplegic stroke patients, 12 months past after onset, able to walk independently with a walker or cane, participated in this study. They were equally and randomly assigned to either one of two groups; Supplementary Walking Group (SWG; n = 12, 61.5 ± 7.4 yrs, 162.2 ± 9.2 cm, 66.4 ± 4.5 kg) or Combined Strength Training Group (CTG; n = 12, 60.0 ± 8.7 yrs, 167.4 ± 10.5 cm, 67.2 ± 1.2 kg). Both groups underwent a 12 weeks program. The program for CTG consisted of whole body strength exercise (upper and lower body, and core exercises) and 6 types of sports activities. Those in SWG participated in the same program as CTG, but they walked for 6 min in fast pace before each session. The time for each session was identical for both groups. They exercised twice a week for 60 min per session. The exercise intensity was maintained at the perceived exertion level between 13 to 15. Before and after the programs, their grip strength (GS), arm curl (AC), sit-up (SU), sit-and-reach (SR), time up & go (TG), 6-min walk test (6WT), visual-reaction test (VT), and leg extension (LE) and flexion (LF) were assessed. RESULTS: For SWG, 6WT and SR increased from 246.5 ± 23.7 to 304.2 ± 26.4 meters (p < 0.001) and from 0.5 ± 0.6 to 6.2 ± 2.1 cm (p < 0.001), respectively. For SWG, TG reduced from 26.8 ± 2.5 to 19.6 ± 1.7 sec (p < 0.001). For SWG, LG on the affected side and unaffected side increased from 21.5 ± 4.8 to 26.9 ± 6.1 kg (p < 0.001), and from 30.9 ± 3.5 to 37.4 ± 4.0 kg (p < 0.001), respectively. For CTG, only SR increased from 4.4 ± 0.8 to 8.4 ± 3.0 cm (p < 0.001). GS, AC, SU, VT, and LF in both groups did not change after the program. CONCLUSIONS: In general, a regular rehabilitative exercise program for hemipletic stroke patients induced a positive physical fitness enhancement. In particular, a supplementary fast walking before rehabilitative program further promoted fitness outcomes such as cardiopulmonary endurance, balance and lower body muscular strength.