Habitual walking speed and fatigue explain self-reported functional capacity after stroke.

INTRODUCTION: Individuals after stroke present several motor impairments, which reduced the functional capacity. The understanding of modifiable factors which are related to functional capacity in individuals with chronic stroke could better direct clinical practice. However, the mechanisms that could influence functional capacity in individuals with chronic stroke are not fully understood. OBJECTIVE: This study aimed to determine which modifiable variables would best predict self-reported functional capacity after stroke. DESIGN: Cross-sectional. SETTING: Research laboratory setting. PARTICIPANTS: Ninety two individuals with chronic stroke, who had a mean age of 60 (SD 13) years and a time since the onset of the stroke of 52 (67) months. MAIN OUTCOME MEASURES: Regression analysis of cross-sectional data was used to investigate whether body mass index, habitual walking speed, physical activity levels, fatigue, motor recovery, walking distance, and residual strength deficits of the lower limb muscles would predict self-reported functional capacity. RESULTS: Habitual walking speed alone explained 48% of the variance in functional capacity. When fatigue was included in the model, the explained variance increased to 55%. CONCLUSIONS: Habitual walking speed and fatigue were significant predictors of self-reported functional capacity in individuals with chronic stroke. These individuals may increase their functional capacity with interventions aimed at increasing walking speed and reducing fatigue.

A single session of moderate intensity walking increases brain-derived neurotrophic factor (BDNF) in the chronic post-stroke patients.

Background Aerobic exercise, even for short durations, may promote an increase in serum concentrations of brain-derived neurotrophic factor (BDNF). However, it is necessary to determine the optimal exercise types and intensities to increase BDNF levels. Objectives This aim of this study was investigate the effects of mild and moderate intensity acute aerobic exercise on serum BDNF levels in patients in the chronic post-stroke phase. Methods The participants answered a socio-demographic questionnaire, cognitive assessment (Mini Mental State Examination), assessment of depressive symptoms (Hamilton Depression Scale), fatigue (Fatigue Severity Scale) and functional capacity (6-minute walk test). Blood samples were collected before and after each session. The measurement of the concentration of BDNF was performed using the enzyme-linked immunosorbent assay . Patients were asked to walk for 30-min in the target training zone (mild intensity, 50-63% of maximum heart rate, and moderate intensity, 64-76% of maximum heart rate), once each week for 2 consecutive weeks. Results Our results indicate that 30 min of acute aerobic exercise at a moderate intensity, but not at a mild intensity, increases serum BDNF levels in the chronic post-stroke phase. Conclusions This study suggests a potential mechanism for the beneficial effects of exercise as a component of recovery from stroke, and provides the basis for future studies that will elucidate the specific parameters for clinical applications.