Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of Aerobic Training on Physical Activity Levels and Sedentary Behavior in Subjects Post-stroke: a Randomized Controlled Trial
Brief Summary: Physical activity level is an important determinant of quality of life in persons post-stroke. There is a lack of knowledge regarding the effects of aerobic training on physical activity levels in subjects post-stroke. Therefore, the primary objective will be to investigate the effects of aerobic treadmill training on physical activity levels and sedentary behavior in subjects post-stroke. The secondary aim will be to investigate the effects of the training on cardiorespiratory fitness, endurance, depression, mobility, quality of life, and participation.

A randomized controlled trial with blinded assessment will assign eligible participants to either: 1) aerobic treadmill training (experimental group, at 60-80% of heart rate reserve), or 2) overground walking (control group, below 40% of heart rate reserve). Both groups will receive 40-minute training sessions three times/week over 12-weeks, in groups of 2-4 participants, by a trained physiotherapist. Primary outcomes: physical activity levels and sedentary behavior (Multisensor SenseWear Mini® and Human Activity Profile). Secondary outcomes: cardiorespiratory fitness (peak oxygen uptake (VO2peak) and ventilatory threshold), endurance, depression, mobility, quality of life, and participation. The effects of the trainings will be analyzed from the collected data and intention-to-treat analysis. Between-groups differences will be measured by two-way ANOVA with repeated measures considering the baseline, post-training, and a 4-week follow-up.

The results of this trial will likely provide valuable new information about the effects of aerobic treadmill training in improving physical activity levels and sedentary behavior, through changes in cardiorespiratory fitness, for individuals following stroke.


Options:
A: Inclusion Criteria:

1. at least 6 months since stroke
2. three or fewer incidents of unilateral stroke confirmed by taking the participant's medical history ability to follow researcher's instructions
3. ability to flex and extend the paretic arm and hand
4. Modified Ashworth Score (MAS) ≦3 for wrist and finger joints
5. Mini-Mental State Examination (MMSE) score should 24 or higher
6. no other orthopedic neurological disorders
7. Brunnstrom stage 3 or 4
8. no joint in other experimental rehabilitation or drug studies 21

Exclusion Criteria:

1. unstable cardiovascular conditions
2. uncontrolled hypertension (190/110 mm Hg)
3. severe orthopedic or pain conditions
4. dementia (Mini-Mental State Examination score \< 22)
5. aphasia with inability to follow researcher's commands
6. severe joint contracture of bilateral upper extremities that would impact the movement performances of upper extremities
B: Inclusion Criteria:

* Diagnosis of stroke according to WHO's definition of stroke
* Living in the city of Trondheim or the municipalities of Asker or Bærum
* Included 2.5 - 4 months after stroke
* Modified Rankin Scale 0 - 4
* Living at home
* Mini Mental State Examination \> 20 or \> 16 if aphasia
* Provide informed consent

Exclusion Criteria:

* Are already included in the study
* Are included in other experimental studies
* Unstable coronary function
* Uncompensated heartfailure
* Other diseases that make it difficult to complete the intervention
C: Inclusion Criteria:

* Primary clinical diagnosis of stroke (assessed by referring clinician/GP records)
* \>1 month (but no upper limit) since discharge from NHS physical rehabilitation services at randomisation
* Able to walk independently indoors with or without mobility aids, but has self-reported difficulty or requires help on stairs, slopes or uneven surfaces (assessed by recruiting team using standard tools)
* Willingness to be randomised to either control or ReTrain (and attend the training venue)
* Cognitive capacity and communication ability sufficient to participate in the study (assessed by recruiting team using standard tools).24 NB: Criterion (3) has been selected pragmatically to maximise eligibility while ensuring participants have a mobility deficit that could be addressed by the intervention. Eligible people with aphasia will not be excluded.

Exclusion Criteria:

* \<18 years old
* Contraindications to moderate to vigorous physical activity. Used in GP screening assessment form. (Adapted from ACSM guidelines 25) Contraindications include:

  * Acute or uncontrolled heart failure
  * Unstable or uncontrolled angina
  * Uncontrolled cardiac dysrhythmia causing symptoms or haemodynamic compromise
  * Symptomatic severe aortic stenosis
  * Current deep vein thrombosis, pulmonary embolus or pulmonary infarction
  * Acute myocarditis or pericarditis
  * Suspected or known dissecting aneurysm
  * Unstable / uncontrolled blood pressure
  * Systolic blood pressure \> 160
  * Diastolic blood pressure \> 100
  * Acute systemic infection
  * Uncontrolled diabetes
D: Inclusion Criteria:

* ≥ 20years of age;
* diagnosis of stroke (\>6months);
* sedentary or insufficiently active;
* have a writing medical permission to participate in the training program.

Exclusion Criteria:

* cognitive impairment (Mini-Mental Status Examination score: illiterate 13 points; elementary and middle school 18 points; and high-school 26 points; or inability to respond to verbal command);
* inability to walk independently for at least 10 minutes, with or without walking devices;
* pain or other disorders precluding their participation.

Answer: D