Effects of a multimodal exercise program on muscle strength, physical performance, and cardiopulmonary endurance in patients with stroke: a randomized controlled pilot study

BACKGROUND: Exercise participation of patients with stroke has many benefits for physical, social, mental, and psychological rehabilitation. Among the exercise methods, conventional circuit training, combined with aerobic and resistance exercises, is the most common type of exercise and has positive effects in improving physical fitness, such as muscle strength, cardiopulmonary endurance, and balance. However, conventional circuit training has the disadvantage of being boring; thus, a multimodal exercise program that combines game elements with a supplementary exercise method is needed. In addition, previous exercise programs studied tended to be boring, as they focused on the therapeutic effect of hospital-based exercise. Additionally, few studies have evaluated the effect of a multimodal exercise program by differentially applying various exercise intensities. Therefore, this study investigated the effect of a multimodal exercise program that combined circuit training, which included resistance training and aerobic exercise, with recreational games to determine how such a program improved muscular strength, physical performance, and cardiopulmonary endurance. METHODS: Participants with stroke were randomly assigned into the exercise (N.=14) and control (N.=14) groups. The exercise group underwent 1-h multimodal exercise training three times a week for 8 weeks, whereas the control group performed balance and toning exercises. RESULTS: Significant increases in muscular strength, physical performance, and cardiopulmonary endurance levels were observed in the exercise group. Regarding muscular strength, significant improvements in knee extension/flexion and trunk extension/flexion were seen in the exercise group. Regarding physical performance, the Berg Balance Scale score and timed up and go test significantly improved in the exercise group. Additionally, regarding cardiopulmonary endurance, the 6-minute walking test results improved significantly in the exercise group. CONCLUSIONS: Our study showed that stroke patients who continued the multimodal exercise program for 8 weeks showed improvements in muscular strength, physical performance, and cardiopulmonary endurance.