Water-based exercise for cardiovascular fitness in people with chronic stroke: a randomized controlled trial

OBJECTIVE: To evaluate the effect of an 8-week, water-based exercise program (experimental group) with that of an upper-extremity function program (control group) to increase cardiovascular fitness within a community setting for people with stroke. DESIGN: Single-blind randomized controlled trial. SETTING: Public community center. PARTICIPANTS: A volunteer sample of 12 community-dwelling people with stroke with mild to moderate residual motor deficits. INTERVENTION: Study subjects participated in group exercise programs for 1 hour, 3 times a week for 8 weeks. The experimental group exercised in chest-deep water at targeted heart rates. The control group performed arm and hand exercises while sitting.Main outcome measures The primary outcome measure was cardiovascular fitness (V(O2)max). Secondary measures were maximal workload, muscle strength, gait speed, and the Berg Balance Scale score. RESULTS: The experimental group attained significant improvements over the control group in cardiovascular fitness, maximal workload, gait speed, and paretic lower-extremity muscle strength. The relatively short program (8 wk) of water-based exercise resulted in a 22% improvement in cardiovascular fitness in a small group of people with stroke who had relatively high function. CONCLUSIONS: A water-based exercise program undertaken as a group program may be an effective way to promote fitness in people with stroke.