Thesis Proposal
Fitness capacity and RESTING HEART RATE VARIABILITY AND BARORECEPTOR sensitivity in post-rehabilitation stroke patients
October 21, 2003
Primary Researcher:
Keith Wohlwend
Graduate Student, Department of Kinesiology
San Francisco State University
Research Advisors:
Dr. Matt Lee, Ph.D.
Assistant Professor, Department of Kinesiology
San Francisco State University
Dr. Marialice Kern, Ph.D.
Associate Professor, Department of Kinesiology
San Francisco State University
1.
Introduction
The aim of the proposed study is to examine the correlation of fitness and cardiovascular autonomic nervous system modulation in post-stroke patients. The study investigates differences of stroke patients with age and sex matched controls. Fitness will be measured by metabolic gas analysis in response to a symptom limited graded exercise test. Autonomic nervous system (ANS) modulation will be tested via heart rate variability (HRV) and baroreceptor sensitivity (BRS). Both measures are non-invasive mathematic computations of the beat-to-beat variation of the heartbeat and systolic and diastolic blood pressure changes respectively. This study will also act as pilot study for the proposed metabolic testing of neurological patients as part of a joint program between the Neurology Department of the University of California at San Francisco and the Kinesiology program at San Francisco State University. The NeuroFit program is aimed at improving the fitness of stroke and other neurological patients via resistance and aerobic exercise training at UCSF. SFSU will conduct the aerobic exercise testing for the evaluation process of patients entering the NeuroFit program. Thus this study will further the understanding of stroke patient rehabilitation efforts at UCSF and to develop safe and effective aerobic exercise testing protocols. But in-order to begin this research more information is needed on the acute response to current aerobic exercise testing in stroke patients.
There has been no study to date that has linked exercise capacity of stroke patients with the resting ANS measures BRS and HRV. Although research has indicated many key relations as listed below. It is hypothesized that the stroke participants will have a reduced exercise capacity and significantly dysregulated sympathovagal modulation compared to normal participants. ANS dysregulation in stroke participants results in high sympathetic influence and reduced parasympathetic influence on HRV and BRS.
A cerberovascular accident, stroke, is a randomly located ischemic or hemorrhagic event occurring in the brain that results in a wide range of neurological disabilities from death to paralysis to minimal psychological manifestations (1). There are currently over 4 million-stroke survivors throughout the United States and approximately 731, 000 new cases every year (2). Although the prevalence of stroke is reducing the absolute number of cases will continue to increase (3). There has b...
