{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T18:26:56Z","timestamp":1766255216167,"version":"3.48.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health","doi-asserted-by":"publisher","award":["R01HD114650"],"award-info":[{"award-number":["R01HD114650"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,29]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Current rehabilitative approaches for the recovery of upper extremity (UE) and lower extremity (LE) function following stroke involve costly time- and personnel-intensive 1-on-1 motor learning-based training. Preliminary data in chronic stroke indicate facilitated aerobic exercise (FE), where volitional LE movements are mechanically supplemented, enhances UE motor recovery associated with task-based practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The goals of the Intensive Stroke Cycling for Optimal Recovery and Economic Value trial are to determine effects of FE in facilitating UE and LE motor recovery post-subacute stroke, to elucidate neural and biochemical substrates of FE-induced motor recovery, and to evaluate cost-effectiveness of a FE-centered intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A prospective, single-center, parallel group, rater-blind, pragmatic randomized clinical trial will be conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The setting will be a large academic medical institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Individuals with hemiparesis due to subacute stroke (N\u2009=\u200966) will be enrolled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Participants will be randomized into FE followed by abbreviated sessions of physical and occupational therapy (FE\u2009+\u2009rehab) or usual care consisting of consecutive sessions of physical and occupational therapy (rehab). All participants will receive a comparable dose of contact time: 90\u00a0minutes, 2 times per week for 12\u00a0weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes<\/jats:title>\n                    <jats:p>Motor outcomes will be collected at baseline, end of treatment (EOT) and EOT\u2009+\u20096\u00a0months. Electroencephalograms and blood biomarkers will be collected at baseline and EOT. Cost-effectiveness will be modeled over immediate and long-term horizons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance<\/jats:title>\n                    <jats:p>The global effect of FE has the potential to enhance recovery in a growing population of stroke survivors in a cost-effective manner, thus accelerating its clinical acceptance. The mechanistic aim will explore the effects of each approach on substrates underlying neuroplasticity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ptj\/pzaf139","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T13:03:59Z","timestamp":1763816639000},"source":"Crossref","is-referenced-by-count":0,"title":["The Intensive Stroke Cycling for Optimal Recovery and Economic Value Trial: Protocol for a Randomized Clinical Trial"],"prefix":"10.1093","volume":"105","author":[{"given":"Courtney R","family":"Miller","sequence":"first","affiliation":[{"name":"Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Neurological Institute , Cleveland, OH 44195 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn","family":"Taylor","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Neurological Institute , Cleveland, OH 44195 ,","place":["United States"]},{"name":"Louis Stokes Cleveland VA Medical Center, Cleveland Functional Electrical Stimulation Center , Cleveland, OH 44106 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francois","family":"Bethoux","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Neurological Institute , Cleveland, OH 44195 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Bischof-Bockbrader","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Department of Physical Medicine and Rehabilitation, Neurological Institute , Cleveland, OH 44195 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara M","family":"DeSilva","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Department of Neurosciences, Lerner Research Institute , Cleveland, OH 44195 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew C","family":"Streicher","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Concussion Center, Neurological Institute , Cleveland, OH 44195 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4314-2282","authenticated-orcid":false,"given":"Brittany","family":"Lapin","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Department of Quantitative Health Sciences, Lerner Research Institute , Cleveland, OH 44195 ,","place":["United States"]},{"name":"Cleveland Clinic, Center for Outcomes Research and Evaluation, Neurological Institute , Cleveland, OH 44195 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belinda L","family":"Udeh","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Department of Quantitative Health Sciences, Lerner Research Institute , Cleveland, OH 44195 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamanna","family":"Singh","sequence":"additional","affiliation":[{"name":"Cleveland Clinic, Department of Cardiovascular Medicine; 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