Effects of aerobic cycling training on cardiovascular fitness and heart rate recovery in patients with chronic stroke

OBJECTIVE: Using heart rate recovery (HRR) after exercise as an index of autonomic function, we evaluate the effects of aerobic cycling training on HRR and cardiovascular fitness (peak VO2) in chronic stroke patients and investigate the relationship between changes in HRR and those in peak VO2. METHODS: 128 participants with chronic stroke were randomized to a 12-week (5×/week) progressive aerobic cycling training group (n = 65) or a control group (n = 63). Peak VO2, muscle strength, 6-minute walking distance (6MWD) and HRR were measured before and after the intervention. RESULTS: Cycling training leads to significant increase in peak VO2, HRR, muscle strength and 6MWD. In the cycling group, percent changes in peak VO2 were positively associated with those in paretic and nonparetic muscle strength and HRR. Linear regression revealed that percent increases in peak VO2 were significantly correlated with percent changes in HRR when controlling for pre-peak VO2, age, gender, duration since stroke and improved muscle strength. CONCLUSION: Aerobic cycling training can favorably modify HRR in stroke survivors. Rapid HRR, as an indicator of enhanced autonomic function, is useful for predicting gains in cardiovascular fitness. These findings indicate the underlying importance of autonomic modulation on cardiovascular adaptations to stroke exercise rehabilitation.