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Published in: Trials 1/2019

Open Access 01-12-2019 | Stroke | Study protocol

Effects of inclined treadmill training on functional and cardiovascular parameters of stroke patients: study protocol for a randomized controlled trial

Authors: Raiff Simplício da Silva, Stephano Tomaz da Silva, Jesimiel Missias de Souza, Marianna Celeste Cordeiro de Figueiredo, Thaís Almeida Silveira Mendes, Maria Clara de Sena Nunes, Samara Katiane Rolim de Oliveira, Daiane Carla Rodrigues Cardoso, Raiza Gabriella da Câmara Silva, Débora Carvalho de Oliveira, Tatiana Souza Ribeiro

Published in: Trials | Issue 1/2019

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Abstract

Background

Treadmill training has been widely used for gait recovery after stroke. Gait re-establishment is one of the main objectives of rehabilitation programs after stroke, aiming to acquire more functional patterns and increase walking speed, along with improvement in cardiovascular function. The aim of this study is to evaluate the effects of a treadmill gait training protocol on functional and cardiovascular variables in patients with chronic stroke.

Methods

A single-blind randomized clinical trial will be conducted. The sample will consist of 36 patients, who will be allocated in three groups: control group (n = 12), experimental group 1 (n = 12), and experimental group 2 (n = 12). The intervention will occur for 6 consecutive weeks, three times a week, 30 min each session, in all groups. The control group will perform a treadmill gait training without inclination, experimental group 1 will perform a treadmill gait training with anterior inclination of 5%, and experimental group 2 will perform a treadmill gait training with anterior inclination of 10%. All participants will be assessed for sample characterization measures, gait speed, functional capacity, systemic arterial blood pressure, heart rate, peripheral oxygen saturation, exercise capacity, neuromuscular torque, and quality of life. Evaluations of outcome measures will occur at the end of the interventions (post-training) and after 1 month and 1 year after the end of the interventions (short- and long-term follow-up). Statistical analysis will be performed descriptively and inferentially. Alpha equals 5% will be considered for inferential analysis. Mixed analysis of variance with repeated measures will be used to compare outcome measures between groups and between baseline, post-training, and follow-up. Normality test (Shapiro–Wilk) and subsequently t test (or Mann–Whitney) will be used to compare groups during the same training session.

Discussion

It is believed that treadmill training, especially treadmill training with anterior inclination, may result in improved exercise capacity in patients with stroke, reduced blood pressure and heart rate values, and an improvement in functional parameters with increased gait speed, functional capacity, quadriceps muscle torque, and quality of life.

Trial registration

Registration in Brazilian Registry of Clinical Trials (ReBEC) identifier RBR-5ffbxz, date of registration October 25 2017.
Appendix
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Literature
1.
go back to reference Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–322.PubMed Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–322.PubMed
2.
go back to reference Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990–2013: The GBD 2013 Study. Neuroepidemiology. 2015;45:161–76.CrossRef Feigin VL, Krishnamurthi RV, Parmar P, Norrving B, Mensah GA, Bennett DA, et al. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990–2013: The GBD 2013 Study. Neuroepidemiology. 2015;45:161–76.CrossRef
3.
go back to reference Brasil. Óbitos p/ Ocorrência segundo Causa - CID-BR-10. In: Informações de Saúde: Estatísticas vitais: mortalidade: Mortalidade geral – 1996 a 2014: Região e Unidade da Federação. Ministério da Saúde. 2014. Available from: http://www.datasus.gov.br. Accessed 15 Mar 2017. Brasil. Óbitos p/ Ocorrência segundo Causa - CID-BR-10. In: Informações de Saúde: Estatísticas vitais: mortalidade: Mortalidade geral – 1996 a 2014: Região e Unidade da Federação. Ministério da Saúde. 2014. Available from: http://​www.​datasus.​gov.​br. Accessed 15 Mar 2017.
4.
go back to reference Bensenor IM, Goulart AC, Szwarcwald CL, Vieira MLFP, Malta DC, Lotufo PA. Prevalence of stroke and associated disability in Brazil: National Health Survey – 2013. Arq Neuropsiquiatr. 2015;73:746–50.CrossRef Bensenor IM, Goulart AC, Szwarcwald CL, Vieira MLFP, Malta DC, Lotufo PA. Prevalence of stroke and associated disability in Brazil: National Health Survey – 2013. Arq Neuropsiquiatr. 2015;73:746–50.CrossRef
6.
go back to reference Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8:741–54.CrossRef Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8:741–54.CrossRef
7.
go back to reference Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: the effect of using a cane. Arch Phys Med Rehabil. 1999;80:777–84.CrossRef Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: the effect of using a cane. Arch Phys Med Rehabil. 1999;80:777–84.CrossRef
8.
go back to reference Chen CL, Chen HC, Tang SF, Wu CY, Cheng PT, Hong WH. Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery. Am J Phys Med Rehabil. 2003;82:925–35.CrossRef Chen CL, Chen HC, Tang SF, Wu CY, Cheng PT, Hong WH. Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery. Am J Phys Med Rehabil. 2003;82:925–35.CrossRef
9.
go back to reference Hollands KL, Pelton TA, Tyson SF, Hollands MA, van Vliet PM. Interventions for coordination of walking following stroke: systematic review. Gait Posture. 2012;35:349–59.CrossRef Hollands KL, Pelton TA, Tyson SF, Hollands MA, van Vliet PM. Interventions for coordination of walking following stroke: systematic review. Gait Posture. 2012;35:349–59.CrossRef
10.
go back to reference Ivey FM, Hafer-Macko CE, Macko RF. Exercise rehabilitation after stroke. NeuroRx. 2006;3:439–50.CrossRef Ivey FM, Hafer-Macko CE, Macko RF. Exercise rehabilitation after stroke. NeuroRx. 2006;3:439–50.CrossRef
11.
go back to reference Stoller O, de Bruin ED, Knols RH, Hunt KJ. Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis. BMC Neurol. 2012;12:45.CrossRef Stoller O, de Bruin ED, Knols RH, Hunt KJ. Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis. BMC Neurol. 2012;12:45.CrossRef
12.
go back to reference Pang MY, Charlesworth SA, Lau RW, Chung RC. Using aerobic exercise to improve health outcomes and quality of life in stroke: evidence-based exercise prescription recommendations. Cerebrovasc Dis. 2013;35:7–22.CrossRef Pang MY, Charlesworth SA, Lau RW, Chung RC. Using aerobic exercise to improve health outcomes and quality of life in stroke: evidence-based exercise prescription recommendations. Cerebrovasc Dis. 2013;35:7–22.CrossRef
13.
go back to reference Raimundo RD, de Abreu LC, Adami F, Vanderlei FM, de Carvalho TD, Moreno IL, et al. Heart rate variability in stroke patients submitted to an acute bout of aerobic exercise. Transl Stroke Res. 2013;4:488–99.CrossRef Raimundo RD, de Abreu LC, Adami F, Vanderlei FM, de Carvalho TD, Moreno IL, et al. Heart rate variability in stroke patients submitted to an acute bout of aerobic exercise. Transl Stroke Res. 2013;4:488–99.CrossRef
14.
go back to reference Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2532–53.CrossRef Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2532–53.CrossRef
15.
go back to reference Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84:1185–93.CrossRef Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84:1185–93.CrossRef
16.
go back to reference Lin PY, Yang YR, Cheng SJ, Wang RY. The relation between ankle impairments and gait velocity and symmetry in people with stroke. Arch Phys Med Rehabil. 2006;87:562–8.CrossRef Lin PY, Yang YR, Cheng SJ, Wang RY. The relation between ankle impairments and gait velocity and symmetry in people with stroke. Arch Phys Med Rehabil. 2006;87:562–8.CrossRef
17.
go back to reference Tang A, Sibley KM, Thomas SG, Bayley MT, Richardson D, McIlroy WE, et al. Effects of an aerobic exercise program on aerobic capacity, spatiotemporal gait parameters, and functional capacity in subacute stroke. Neurorehabil Neural Repair. 2009;23:398–406.CrossRef Tang A, Sibley KM, Thomas SG, Bayley MT, Richardson D, McIlroy WE, et al. Effects of an aerobic exercise program on aerobic capacity, spatiotemporal gait parameters, and functional capacity in subacute stroke. Neurorehabil Neural Repair. 2009;23:398–406.CrossRef
18.
go back to reference Jørgensen JR, Bech-Pedersen DT, Zeeman P, Sørensen J, Andersen LL, Schönberger M. Effect of intensive outpatient physical training on gait performance and cardiovascular health in people with hemiparesis after stroke. Phys Ther. 2010;90:527–37.CrossRef Jørgensen JR, Bech-Pedersen DT, Zeeman P, Sørensen J, Andersen LL, Schönberger M. Effect of intensive outpatient physical training on gait performance and cardiovascular health in people with hemiparesis after stroke. Phys Ther. 2010;90:527–37.CrossRef
19.
go back to reference Duncan P, Richards L, Wallace D, Stoker-Yates J, Pohl P, Luchies C, et al. A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke. 1998;29:2055–60.CrossRef Duncan P, Richards L, Wallace D, Stoker-Yates J, Pohl P, Luchies C, et al. A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke. 1998;29:2055–60.CrossRef
20.
go back to reference Globas C, Becker C, Cerny J, Lam JM, Lindemann U, Forrester LW, et al. Chronic stroke survivors benefit from high intensity aerobic treadmill exercise: a randomized controlled trial. Neurorehabil Neural Repair. 2012;26:85–95.CrossRef Globas C, Becker C, Cerny J, Lam JM, Lindemann U, Forrester LW, et al. Chronic stroke survivors benefit from high intensity aerobic treadmill exercise: a randomized controlled trial. Neurorehabil Neural Repair. 2012;26:85–95.CrossRef
21.
go back to reference Letombe A, Cornille C, Delahaye H, Khaled A, Morice O, Tomaszewski A, et al. Early post-stroke physical conditioning in hemiplegic patients: a preliminary study. Ann Phys Rehabil Med. 2010;53:632–42.CrossRef Letombe A, Cornille C, Delahaye H, Khaled A, Morice O, Tomaszewski A, et al. Early post-stroke physical conditioning in hemiplegic patients: a preliminary study. Ann Phys Rehabil Med. 2010;53:632–42.CrossRef
22.
go back to reference Macko RF, Ivey FM, Forrester LW, Hanley D, Sorkin JD, Katzel LI, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005;36:2206–11.CrossRef Macko RF, Ivey FM, Forrester LW, Hanley D, Sorkin JD, Katzel LI, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005;36:2206–11.CrossRef
23.
go back to reference Carda S, Invernizzi M, Baricich A, Cognolato G, Cisari C. Does altering inclination alter effectiveness of treadmill training for gait impairment after stroke? A randomized controlled trial. Clin Rehabil. 2013;27:932–8.CrossRef Carda S, Invernizzi M, Baricich A, Cognolato G, Cisari C. Does altering inclination alter effectiveness of treadmill training for gait impairment after stroke? A randomized controlled trial. Clin Rehabil. 2013;27:932–8.CrossRef
24.
go back to reference Herber V, Michaelsen SM, Ovando AC. Spatial temporal characteristics of backward walking in individuals with hemiparesis. Motriz. 2011;17:675–82. Herber V, Michaelsen SM, Ovando AC. Spatial temporal characteristics of backward walking in individuals with hemiparesis. Motriz. 2011;17:675–82.
25.
go back to reference Ribeiro TS, Silva EMGS, Silva IAP, Costa MFP, Cavalcanti FAC, Lindquist AR. Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: A randomized controlled clinical trial. Gait Posture. 2017;54:229–35.CrossRef Ribeiro TS, Silva EMGS, Silva IAP, Costa MFP, Cavalcanti FAC, Lindquist AR. Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: A randomized controlled clinical trial. Gait Posture. 2017;54:229–35.CrossRef
26.
go back to reference Gama GL, de Lucena Trigueiro LC, Simão CR, de Sousa AV, de Souza E Silva EM, Galvão ÉR, et al. Effects of treadmill inclination on hemiparetic gait: controlled and randomized clinical trial. Am J Phys Med Rehabil. 2015;94:718–27.CrossRef Gama GL, de Lucena Trigueiro LC, Simão CR, de Sousa AV, de Souza E Silva EM, Galvão ÉR, et al. Effects of treadmill inclination on hemiparetic gait: controlled and randomized clinical trial. Am J Phys Med Rehabil. 2015;94:718–27.CrossRef
27.
go back to reference Moreno CC, Mendes LA, Lindquist AR. Effects of treadmill inclination on the gait of individuals with chronic hemiparesis. Arch Phys Med Rehabil. 2011;92:1675–80.CrossRef Moreno CC, Mendes LA, Lindquist AR. Effects of treadmill inclination on the gait of individuals with chronic hemiparesis. Arch Phys Med Rehabil. 2011;92:1675–80.CrossRef
28.
go back to reference Werner C, Lindquist AR, Bardeleben A, Hesse S. The influence of treadmill inclination on the gait of ambulatory hemiparetic subjects. Neurorehabil Neural Repair. 2007;21:76–80.CrossRef Werner C, Lindquist AR, Bardeleben A, Hesse S. The influence of treadmill inclination on the gait of ambulatory hemiparetic subjects. Neurorehabil Neural Repair. 2007;21:76–80.CrossRef
32.
go back to reference Hiengkaew V, Jitaree K, Chaiyawat P. Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed "Up & Go" Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. Arch Phys Med Rehabil. 2012;93:1201–8.CrossRef Hiengkaew V, Jitaree K, Chaiyawat P. Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed "Up & Go" Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. Arch Phys Med Rehabil. 2012;93:1201–8.CrossRef
33.
go back to reference Mehrholz J, Wagner K, Rutte K, Meissner D, Pohl M. Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88:1314–9.CrossRef Mehrholz J, Wagner K, Rutte K, Meissner D, Pohl M. Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88:1314–9.CrossRef
34.
go back to reference Fulk GD, He Y, Boyne P, Dunning K. Predicting Home and Community Walking Activity Poststroke. Stroke. 2017;48:406–11.CrossRef Fulk GD, He Y, Boyne P, Dunning K. Predicting Home and Community Walking Activity Poststroke. Stroke. 2017;48:406–11.CrossRef
35.
go back to reference Remme WJ, Swedberg K, Task Force for the Diagnosis and Treatment of Chronic Heart Failure, European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J. 2001;22:1527–60.CrossRef Remme WJ, Swedberg K, Task Force for the Diagnosis and Treatment of Chronic Heart Failure, European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J. 2001;22:1527–60.CrossRef
36.
go back to reference Balady GJ, Chaitman B, Driscoll D, Foster C, Froelicher E, Gordon N, et al. American College of Sports Medicine Position Stand and American Heart Association. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. Circulation. 1998;97:2283–93.CrossRef Balady GJ, Chaitman B, Driscoll D, Foster C, Froelicher E, Gordon N, et al. American College of Sports Medicine Position Stand and American Heart Association. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. Circulation. 1998;97:2283–93.CrossRef
37.
go back to reference Fox SM 3rd, Naughton JP, Haskell WL. Physical activity and the prevention of coronary heart disease. Ann Clin Res. 1971;3:404–32.PubMed Fox SM 3rd, Naughton JP, Haskell WL. Physical activity and the prevention of coronary heart disease. Ann Clin Res. 1971;3:404–32.PubMed
39.
go back to reference Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7:13–31.PubMed Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7:13–31.PubMed
40.
go back to reference Maki T, Quagliato EMAB, Cacho EWA, Paz LPS, Nascimento NH, Inoue MMEA, et al. Reliability study on the application of the Fugl-Meyer scale in Brazil. Braz J Phys Ther. 2006;10:177–83.CrossRef Maki T, Quagliato EMAB, Cacho EWA, Paz LPS, Nascimento NH, Inoue MMEA, et al. Reliability study on the application of the Fugl-Meyer scale in Brazil. Braz J Phys Ther. 2006;10:177–83.CrossRef
41.
go back to reference Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing. 1997;26:15–9.CrossRef Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing. 1997;26:15–9.CrossRef
42.
go back to reference Hollman JH, Beckman BA, Brandt RA, Merriwether EN, Williams RT, Nordrum JT. Minimum detectable change in gait velocity during acute rehabilitation following hip fracture. J Geriatr Phys Ther. 2008;31:53–6.CrossRef Hollman JH, Beckman BA, Brandt RA, Merriwether EN, Williams RT, Nordrum JT. Minimum detectable change in gait velocity during acute rehabilitation following hip fracture. J Geriatr Phys Ther. 2008;31:53–6.CrossRef
43.
go back to reference Stewart DA, Burns JMA, Dunn SG, Roberts MA. The two-minute walking test: a sensitive index of mobility in the rehabilitation of elderly patients. Clin Rehabil. 1990;4:273–6.CrossRef Stewart DA, Burns JMA, Dunn SG, Roberts MA. The two-minute walking test: a sensitive index of mobility in the rehabilitation of elderly patients. Clin Rehabil. 1990;4:273–6.CrossRef
44.
go back to reference Kosak M, Smith T. Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev. 2005;42:103–7.PubMed Kosak M, Smith T. Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev. 2005;42:103–7.PubMed
46.
go back to reference Wicks JR, Oldridge NB, Nielsen LK, Vickers CE. HR index-a simple method for the prediction of oxygen uptake. Med Sci Sports Exerc. 2011;43:2005–12.PubMed Wicks JR, Oldridge NB, Nielsen LK, Vickers CE. HR index-a simple method for the prediction of oxygen uptake. Med Sci Sports Exerc. 2011;43:2005–12.PubMed
47.
go back to reference Hsu AL, Tang PF, Jan MH. Test-retest reliability of isokinetic muscle strength of the lower extremities in patients with stroke. Arch Phys Med Rehabil. 2002;83:1130–7.CrossRef Hsu AL, Tang PF, Jan MH. Test-retest reliability of isokinetic muscle strength of the lower extremities in patients with stroke. Arch Phys Med Rehabil. 2002;83:1130–7.CrossRef
48.
go back to reference Pohl PS, Duncan P, Perera S, Long J, Liu W, Zhou J, et al. Rate of isometric knee extension strength development and walking speed after stroke. J Rehabil Res Dev. 2002;39:651–7.PubMed Pohl PS, Duncan P, Perera S, Long J, Liu W, Zhou J, et al. Rate of isometric knee extension strength development and walking speed after stroke. J Rehabil Res Dev. 2002;39:651–7.PubMed
49.
go back to reference Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a Stroke-Specific Quality of Life Scale. Stroke. 1999;30:1362–9.CrossRef Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a Stroke-Specific Quality of Life Scale. Stroke. 1999;30:1362–9.CrossRef
50.
go back to reference Lima RCM, Teixeira-Salmela LF, Magalhães LC, Gomes-Neto M. Psychometric properties of the Brazilian version of the Stroke Specific Quality of Life Scale: application of the Rasch model. Braz J Phys Ther. 2008;12:149–56. Lima RCM, Teixeira-Salmela LF, Magalhães LC, Gomes-Neto M. Psychometric properties of the Brazilian version of the Stroke Specific Quality of Life Scale: application of the Rasch model. Braz J Phys Ther. 2008;12:149–56.
51.
go back to reference Borg G, Hassmén P, Lagerström M. Perceived exertion related to heart rate and blood lactate during arm and leg exercise. Eur J Appl Physiol Occup Physiol. 1987;56:679–85.CrossRef Borg G, Hassmén P, Lagerström M. Perceived exertion related to heart rate and blood lactate during arm and leg exercise. Eur J Appl Physiol Occup Physiol. 1987;56:679–85.CrossRef
52.
go back to reference Foster C, Florhaug JA, Franklin J, Gottschall L, Hrovatin LA, Parker S, et al. A new approach to monitoring exercise training. J Strength Cond Res. 2001;15:109–15.PubMed Foster C, Florhaug JA, Franklin J, Gottschall L, Hrovatin LA, Parker S, et al. A new approach to monitoring exercise training. J Strength Cond Res. 2001;15:109–15.PubMed
53.
go back to reference Ribeiro TS, Chaves da Silva TC, Carlos R, de Souza E Silva EMG, Lacerda MO, Spaniol AP, et al. Is there influence of the load addition during treadmill training on cardiovascular parameters and gait performance in patients with stroke? A randomized clinical trial. NeuroRehabilitation. 2017;40:345–54.CrossRef Ribeiro TS, Chaves da Silva TC, Carlos R, de Souza E Silva EMG, Lacerda MO, Spaniol AP, et al. Is there influence of the load addition during treadmill training on cardiovascular parameters and gait performance in patients with stroke? A randomized clinical trial. NeuroRehabilitation. 2017;40:345–54.CrossRef
54.
go back to reference American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. Baltimore: Lippincott, Williams & Wilkins; 2006. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. Baltimore: Lippincott, Williams & Wilkins; 2006.
Metadata
Title
Effects of inclined treadmill training on functional and cardiovascular parameters of stroke patients: study protocol for a randomized controlled trial
Authors
Raiff Simplício da Silva
Stephano Tomaz da Silva
Jesimiel Missias de Souza
Marianna Celeste Cordeiro de Figueiredo
Thaís Almeida Silveira Mendes
Maria Clara de Sena Nunes
Samara Katiane Rolim de Oliveira
Daiane Carla Rodrigues Cardoso
Raiza Gabriella da Câmara Silva
Débora Carvalho de Oliveira
Tatiana Souza Ribeiro
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3298-3

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