Background: Stroke is the second leading cause of death and disability worldwide and in Hong Kong, 6.2% of all registered deaths in 2020 were due to cerebrovascular disease. Exercise training has the potential to improve the deconditioned hemodynamic, motor, and cognitive functions associated with stroke. Purpose: The proposed study seeks to investigate the effects of AET on the large intracranial and extracranial cerebral arteries' morphological and haemodynamic features and the cognitive and motor functions in post-stroke chronic patients. Additionally, the study seeks to compare the cerebral arteries' features between post-stroke patients and age-matched controls without stroke. Furthermore, the project seeks to assess the association between the cerebrovascular system changes and the cognitive and motor function changes in post-stroke patients undergoing AET. Study Design: A Randomised controlled trial (RCT) in which the post-stroke patients will be randomly assigned into three groups consisting of a control group and two AET interventional groups (treadmill and cycle ergometer). Each group will target sample size of 20 participants. The target dosage for the two AET modes will consist of 1.) a session duration=30mins, 2.) frequency=3times/week, 3.) high intensity=(60-84% heart rate reserve (HHR).4.) Types=Treadmill and cycle ergometer 5.) overall program duration=3months. Data collection methods: Quantitative data on the cerebral arteries' haemodynamic and morphological features will be assessed using duplex carotid ultrasound (DCUS) and transcranial Doppler (TCD) ultrasound techniques. Montreal cognitive assessment (HK) version and six-minute walk test (6MWT) will assess cognitive and motor functions respectively. The data will be assessed at three time periods of during the 3 months AET program Significance of the study: The study has the potential to inform the clinical decision making process on the usefulness of AET in improving post-stroke chronic patients. Results on associations will provide a basis for future work in chronic stroke Rehabilitation functional outcome prediction models based on DCUS and TCD ultrasound imaging techniques.
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Changes in the carotid intima media thickness (CIMT) following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography.
Timeframe: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the Carotid arterial stiffness (CAS) following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography.
Timeframe: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the degree of stenosis following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography.
Timeframe: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the plaque Gray scale median values (GSM) following a 12weeks Aerobic exercise training (AET) programme as assessed by the Adobe Photoshop software.
Timeframe: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the cerebral arteries' Peak systolic velocity (PSV) following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography (DCUS) and Transcranial Doppler (TCD) Ultrasonography.
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the cerebral arteries' End diastolic velocity (EDV) following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography.
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the cerebral arteries' mean flow velocity (MFV) following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography.
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the cerebral arteries' Resistivity index (RI) following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography.
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the cerebral arteries' Pulsatility index (PI) following a 12weeks Aerobic exercise training (AET) programme as assessed by duplex carotid ultrasonography.
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the cognitive function as assessed by Montreal Cognitive assessment Hong Kong version Tool.
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the cognitive function as assessed by the Stroop word color Test (SWCT)Tool.
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the motor function as assessed by the six minute walk test
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Changes in the motor function as assessed by the Timed up and go test(TUG).
Timeframe: Time Frame: Baseline(enrollment) to midpoint of AET at 6weeks and Baseline to end of AET at 12weeks
Differences between the post-stroke patients and age-matched non-stroke subjects' carotid intima media thickness (CIMT) as assessed by duplex carotid ultrasonography.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' Carotid arterial stiffness (CAS), Beta Stiffness Index (β) as assessed by duplex carotid ultrasonography.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' degree of volume stenosis as assessed by 3 dimensional(3D) carotid ultrasonography.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' Plaque Gray scale median (GSM) values as assessed by Adobe Photoshop software.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' cerebral arteries Peak systolic velocity (PSV) as assessed by Duplex carotid ultrasonography (DCUS) and Transcranial Doppler (TCD) ultrasonography.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' cerebral arteries End diastolic velocity (EDV) as assessed by Duplex carotid ultrasonography (DCUS) and transcranial Doppler (TCD) ultrasonography.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' cerebral arteries Mean flow velocity (MFV) as assessed by Duplex carotid ultrasonography (DCUS) and transcranial Doppler (TCD) ultrasonography.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' cerebral arteries Resistivity Index (RI) as assessed by Duplex carotid ultrasonography (DCUS) and transcranial Doppler (TCD) ultrasonography.
Timeframe: single point-Baseline
Differences between the post-stroke patients and age-matched non-stroke subjects' cerebral arteries Pulsatility Index (PI) as assessed by Duplex carotid ultrasonography (DCUS) and transcranial Doppler (TCD) ultrasonography.
Timeframe: single point-Baseline