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:

* 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
B: Inclusion Criteria:

1. 40-85 years old ischemic Stroke patients,
2. Stroke onset \<90 days at enrollment,
3. Hemiparetic gait disorder,
4. Patients able to walk 30ft with or w/out assistive device,
5. Sufficient English comprehension to understand instructions, provide consent, and answer questions,
6. Lives within 30 miles of the Greater Baltimore area.

Exclusion Criteria:

1. Dementia (extended MMSE \<85 or \<80 if education level below 9th grade),
2. Untreated major clinical depression (CES-D\>16) and confirmed with clinical interview,
3. Heavy alcohol use (\<3 oz liquor, 3, 4-oz glasses of wine, or 3, 12- oz beers daily),
4. Active cancer, or any illness with a life expectancy of less than 6 months,
5. Any condition in which exercise activity would be contraindicated including, but not limited to: unstable angina, cardiac ischemic event within the past 6 months, congestive heart failure (Stage III or IV), major orthopedic chronic pain or non-stroke neuromuscular disorders restricting exercise, oxygen-dependent COPD or peripheral neuropathy.
C: 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.
D: Inclusion Criteria:

* Post stroke survivors of single unilateral stroke
* discharged from rehabilitation
* the ability to walk independently, with or without using an aid or orthosis
* sufficient cognitive ability,
* the ability to comprehend instruction

Exclusion Criteria:

* history of serious cardiac disease (e.g. myocardial infarction, unstable angina)
* uncontrolled blood pressure
* significant neurological or musculoskeletal conditions in addition to stroke

Answer: C