Study determines exercise dose for stroke recovery
A unique Calgary lab is focused on the only medicine proven to prevent, manage and reverse the progression of chronic disease.
As part of a national study called DOSE (Determining Optimal post-Stroke Exercise) and funded by the HSF Canadian Partnership for Stroke Recovery (CPSR), Dr. Marc Poulin and Dr. Sean Dukelow are calculating the dose of exercise to give stroke patients the intensity required to achieve the best possible results.
“Exercise has a huge role in recovery and we are just starting to exploit and understand it,” says Dr. Poulin, who heads up the newly-opened clinical and translational research lab at the Hotchkiss Brain Institute at the University of Calgary’s Cumming School of Medicine. “There are no guidelines for the amount and kind of exercise that’s optimal for stroke recovery.”
The trial is examining three different levels of post-stroke exercise delivered over 20 days. The first group receives the standard of care, the second group gets a structured one hour of exercise a day, and the third receives a structured two hours a day. At the end, researchers measure changes in cardiovascular fitness, walking, mobility, cognition and quality of life.
The 75-patient study involves two sites in Calgary, four sites in Vancouver and one site in Toronto.
In each therapy session, patients are pushed to work as hard as possible.
“The underlying idea is the harder we push and the longer we push the better the outcome we have,” says Dr. Dukelow, who is a physiatrist (a medical doctor who specializes in rehabilitation), a PhD neuroscientist and CPSR site leader in Calgary. “We won’t know what the outcome is until we’ve finished the study,” which is expected in the spring. But, he adds, “It’s the first time I’ve seen a therapist run up and down the hallway with a patient after stroke.”
Chris Duffield, 48, a Calgary technology consultant who had a stroke that left him paralyzed on one side, is among the study participants. By taking part in DOSE, Duffield says “exercise has helped build my strength and my confidence too … I’m really happy to be part of this.”
At Calgary’s clinical and translational research lab, Duffield and other patients pedal on an adapted cycling ergometer, which looks like a fancy exercise bicycle, while his blood pressure and heart rate are monitored.
““We know being sedentary is a risk factor for stroke and it can play a role in accelerating recovery,” says Dr. Poulin, an international expert in exercise to promote brain health and healthy brain aging. His research is also focused on the connection between sleep quality and stroke.
Since moving to Calgary 16 years ago after completing a PhD — his second — at Oxford University, Dr. Poulin says he has been able to do exciting interdisciplinary research that brings meaningful change to patients. “It’s an exciting place to be. I feel very lucky to have this opportunity.”
Best of all, Dr. Poulin gets to focus on his “passion for exercise and appreciation for how good it makes you feel. It’s an important part of healthy living.”