{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:19:42Z","timestamp":1791256782432,"version":"4.1.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T00:00:00Z","timestamp":1621209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013873","name":"Government of Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013873","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Stroke is a highly disabling condition and is the second leading cause of death globally. Engaging in aerobic exercise is important for the prevention of a recurrent stroke through improving markers of cardiovascular health such as blood pressure and arterial stiffness. While higher intensities of aerobic exercise generally elicit greater cardioprotective effects, little is known about the acute cardiovascular effects of a single session of high intensity aerobic exercise in people with stroke. The objective of this study was to model the recovery of arterial stiffness (carotid-femoral pulse wave velocity, cfPWV), heart rate and blood pressure following peak intensity aerobic exercise in individuals with chronic stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten participants with chronic stroke (mean \u00b1 SD age = 56.9 \u00b1 11.8 years, median [IQR] years post-stroke = 2.9 [1.9]) performed a symptom-limited cardiopulmonary exercise test (CPET) on a recumbent stepper. Before the CPET, resting cfPWV, heart rate and blood pressure were measured. Immediately following the CPET, all outcomes were measured again continuously for 20 min to use all available observations (<jats:italic>n<\/jats:italic> = 245 observations) and capture any potential non-linear changes. Mixed model analyses were then applied to model post-exercise changes of cfPWV, heart rate and blood pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Carotid-femoral pulse wave velocity was increased from rest following the CPET (9.0 \u00b1 0.53 to 9.9 \u00b1 0.52 m\/s, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and remained elevated for 20 min into post-exercise recovery, independent of heart rate (<jats:italic>p<\/jats:italic> = 0.001). Heart rate also increased from baseline (71.2 \u00b1 3.2 to 77.4 \u00b1 3.1 bpm, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and remained elevated for 10 min post-exercise (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Finger systolic blood pressure was reduced from rest (117.3 \u00b1 4.7 to 111.8 \u00b1 4.6 mmHg, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) and remained reduced for 15 min after exercise (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). There were no significant differences in finger diastolic or mean arterial pressures from rest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This was the first study to capture continuous changes in cfPWV following peak aerobic exercise in any clinical population. The present study revealed that cfPWV is elevated for 20 min after peak aerobic exercise in individuals with stroke, which was independent of heart rate. These findings suggest there may be autonomic imbalances in large arteries following peak intensity aerobic exercise in individuals with stroke.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2021.666171","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T05:02:15Z","timestamp":1621227735000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke"],"prefix":"10.3389","volume":"12","author":[{"given":"Kenneth S.","family":"Noguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Moncion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Wiley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen J.","family":"MacDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Roig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1556","DOI":"10.1519\/JSC.0b013e3181739dd7","article-title":"Validity of a total body recumbent stepper exercise test to assess cardiorespiratory fitness.","volume":"22","author":"Billinger","year":"2008","journal-title":"J. Strength Cond. Res."},{"key":"B2","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion.","volume":"14","author":"Borg","year":"1982","journal-title":"Med. Sci. Sports Exerc."},{"key":"B3","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1161\/01.str.20.7.864","article-title":"Measurements of acute cerebral infarction: a clinical examination scale.","volume":"20","author":"Brott","year":"1989","journal-title":"Stroke"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.13226","article-title":"The effect of acute maximal exercise on postexercise hemodynamics and central arterial stiffness in obese and normal-weight individuals.","volume":"5","author":"Bunsawat","year":"2017","journal-title":"Physiol. Rep."},{"key":"B5","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s12265-012-9359-6","article-title":"Arterial Stiffness: basic concepts and measurement techniques.","volume":"5","author":"Chirinos","year":"2012","journal-title":"J. Cardiovasc. Trans. Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1177\/0269215517709051","article-title":"Effects of exercise on cardiovascular risk factors following stroke or transient ischemic attack: a systematic review and meta-analysis.","volume":"31","author":"D\u2019Isabella","year":"2017","journal-title":"Clin. Rehabilit."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.19394","article-title":"Analyzing repeated measurements using mixed models.","volume":"315","author":"Detry","year":"2016","journal-title":"JAMA"},{"key":"B8","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1038\/hr.2012.158","article-title":"Differences in arterial stiffness at rest and after acute exercise between young men and women.","volume":"36","author":"Doonan","year":"2013","journal-title":"Hypertens Res."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0026151","article-title":"Altered arterial stiffness and subendocardial viability ratio in young healthy light smokers after acute exercise.","volume":"6","author":"Doonan","year":"2011","journal-title":"PLoS One"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1002\/cphy.c140016","article-title":"Effects of stroke on the autonomic nervous system.","volume":"5","author":"Dorrance","year":"2015","journal-title":"Compr. Physiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1981","DOI":"10.1097\/hjh.0000000000000654","article-title":"Reference values for local arterial stiffness. Part A: carotid artery.","volume":"33","author":"Engelen","year":"2015","journal-title":"J. Hyperten."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.1164\/ajrccm.158.5.9710086","article-title":"Reference equations for the six-minute walk in healthy adults.","volume":"158","author":"Enright","year":"1998","journal-title":"Am. J. Respirat. Crit. Care Med."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.119.012601","article-title":"Arterial stiffness can be modulated by pressure-independent mechanisms in hypertension.","volume":"8","author":"Faconti","year":"2019","journal-title":"J. Am. Heart. Assoc."},{"key":"B14","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/j.atherosclerosis.2012.09.024","article-title":"Pulse wave velocity is associated with early clinical outcome after ischemic stroke.","volume":"225","author":"G\u0105secki","year":"2012","journal-title":"Atherosclerosis"},{"key":"B15","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1111\/jch.12340","article-title":"Exercise-induced pulse wave velocity changes in untreated patients with essential hypertension: the effect of an angiotensin receptor antagonist.","volume":"16","author":"Gkaliagkousi","year":"2014","journal-title":"J. Clin. Hyperten."},{"key":"B16","doi-asserted-by":"publisher","first-page":"327","DOI":"10.3233\/nre-130852","article-title":"Effects of aerobic cycling training on cardiovascular fitness and heart rate recovery in patients with chronic stroke.","volume":"32","author":"Jin","year":"2013","journal-title":"NeuroRehabilitation"},{"key":"B17","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/s1474-4422(19)30034-1","article-title":"Global, regional, and national burden of stroke, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016.","volume":"18","author":"Johnson","year":"2019","journal-title":"Lancet Neurol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1002\/pmrj.12259","article-title":"Safety of performing a graded exercise test early after stroke and transient ischemic attack.","volume":"12","author":"Johnson","year":"2020","journal-title":"PM R"},{"key":"B19","doi-asserted-by":"publisher","first-page":"65","DOI":"10.3122\/jabfm.2007.01.060128","article-title":"Transcranial doppler: an introduction for primary care physicians.","volume":"20","author":"Kassab","year":"2007","journal-title":"J. Am. Board Fam. Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1038\/jhh.2013.5","article-title":"Exercise aortic stiffness: reproducibility and relation to end-organ damage in men.","volume":"27","author":"Keith","year":"2013","journal-title":"J. Hum. Hyperten."},{"key":"B21","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1037\/1082-989X.6.3.282","article-title":"Mixed-model pairwise multiple comparisons of repeated measures means.","volume":"6","author":"Kowalchuk","year":"2001","journal-title":"Psychol. Methods"},{"key":"B22","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.pharmthera.2010.02.002","article-title":"Sympathetic nervous activation in obesity and the metabolic syndrome\u2013causes, consequences and therapeutic implications.","volume":"126","author":"Lambert","year":"2010","journal-title":"Pharmacol. Ther."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1097\/hjh.0000000000001752","article-title":"Effects of acute aerobic exercise on arterial stiffness and cerebrovascular pulsatility in adults with and without hypertension.","volume":"36","author":"Lefferts","year":"2018","journal-title":"J. Hypert."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000016938","article-title":"Impaired heart rate recovery as a predictor for poor health-related quality in patients with transient ischemic attack.","volume":"98","author":"Li","year":"2019","journal-title":"Medicine"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.115.002014","article-title":"Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta\u2212analysis of randomized controlled trials.","volume":"4","author":"Lin","year":"2015","journal-title":"J. Am. Heart Associat."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1804","DOI":"10.1161\/circresaha.114.302524","article-title":"The autonomic nervous system and hypertension.","volume":"114","author":"Mancia","year":"2014","journal-title":"Circulat. Res."},{"key":"B27","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1097\/00004872-199607000-00013","article-title":"Heart rate-dependence of arterial distensibility in vivo.","volume":"14","author":"Mangoni","year":"1996","journal-title":"J. Hyperten."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.1016\/j.jacc.2014.06.1201","article-title":"Adverse effects of cigarette and noncigarette smoke exposure on the autonomic nervous system: mechanisms and implications for cardiovascular risk.","volume":"64","author":"Middlekauff","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1177\/0013164415580432","article-title":"Alternative models for small samples in psychological research.","volume":"76","author":"Muth","year":"2016","journal-title":"Educ. Psychol. Measur."},{"key":"B30","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1038\/hr.2016.111","article-title":"A systematic review on the effect of acute aerobic exercise on arterial stiffness reveals a differential response in the upper and lower arterial segments.","volume":"40","author":"Mutter","year":"2017","journal-title":"Hyperten. Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1161\/01.str.12.2.200","article-title":"Plasma norepinephrine in stroke.","volume":"12","author":"Myers","year":"1981","journal-title":"Stroke"},{"key":"B32","doi-asserted-by":"publisher","first-page":"H1338","DOI":"10.1152\/ajpheart.00734.2020","article-title":"Sympathetic neural modulation of arterial stiffness in humans.","volume":"319","author":"Nardone","year":"2020","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1177\/1545968317718269","article-title":"A Single Bout of high-intensity interval training improves motor skill retention in individuals with stroke.","volume":"31","author":"Nepveu","year":"2017","journal-title":"Neuroreh. Neural Repair"},{"key":"B34","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/s0140-6736(10)60834-3","article-title":"Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study.","volume":"376","author":"O\u2019Donnell","year":"2010","journal-title":"Lancet"},{"key":"B35","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1111\/cpf.12537","article-title":"Reliability of arterial stiffness indices at rest and following a single bout of moderate-intensity exercise in older adults.","volume":"39","author":"Perissiou","year":"2019","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.00073","article-title":"Acute effects of exercise mode on arterial stiffness and wave reflection in healthy young adults: a systematic review and meta-analysis.","volume":"9","author":"Pierce","year":"2018","journal-title":"Front. Physiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"2637","DOI":"10.1161\/strokeaha.111.642264","article-title":"Arterial stiffness and cerebral small vessel disease.","volume":"43","author":"Poels","year":"2012","journal-title":"Stroke"},{"key":"B38","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.dsx.2016.08.013","article-title":"Acute changes in arterial stiffness following exercise in people with metabolic syndrome.","volume":"11","author":"Radhakrishnan","year":"2017","journal-title":"Diab. Metab. Syndr. Clin. Res. Rev."},{"key":"B39","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1007\/s00421-008-0964-7","article-title":"Effect of acute sprint interval exercise on central and peripheral artery distensibility in young healthy males.","volume":"105","author":"Rakobowchuk","year":"2009","journal-title":"Eur. J. Appl. Physiol."},{"key":"B40","author":"Riebe","year":"2018","journal-title":"ACSM Guidelines for Exercise Testing &amp; Prescription."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1152\/japplphysiol.00137.2019","article-title":"Aging reduces cerebral blood flow regulation following an acute hypertensive stimulus.","volume":"128","author":"Rosenberg","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1161\/hypertensionaha.116.07462","article-title":"Heart Rate dependency of large artery stiffness.","volume":"68","author":"Tan","year":"2016","journal-title":"Hypertension"},{"key":"B43","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.01.020","article-title":"Physical activity correlates with arterial stiffness in community-dwelling individuals with stroke.","volume":"23","author":"Tang","year":"2014","journal-title":"J. Stroke Cerebrovas. Dis."},{"key":"B44","doi-asserted-by":"publisher","first-page":"2116","DOI":"10.1016\/j.jacc.2015.08.888","article-title":"Carotid stiffness is associated with incident stroke: a systematic review and individual participant data meta-analysis.","volume":"66","author":"van Sloten","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1161\/01.str.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients.","volume":"19","author":"Van Swieten","year":"1988","journal-title":"Stroke"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1016\/j.jacc.2009.10.061","article-title":"Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis.","volume":"55","author":"Vlachopoulos","year":"2010","journal-title":"J. Am. Coll. Cardiol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.artres.2010.03.001","article-title":"ARTERY Society guidelines for validation of non-invasive haemodynamic measurement devices: Part 1, arterial pulse wave velocity.","volume":"4","author":"Wilkinson","year":"2010","journal-title":"Artery Res."},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0172294","article-title":"Recumbent stepper submaximal test response is reliable in adults with and without stroke.","volume":"12","author":"Wilson","year":"2017","journal-title":"PLoS One"},{"key":"B49","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1161\/01.atv.0000160548.78317.29","article-title":"Mechanisms, pathophysiology, and therapy of arterial stiffness.","volume":"25","author":"Zieman","year":"2005","journal-title":"Arterioscl. Thromb. Vascul. Biol."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.666171\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T05:02:19Z","timestamp":1621227739000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.666171\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,17]]},"references-count":49,"alternative-id":["10.3389\/fphys.2021.666171"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2021.666171","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,17]]},"article-number":"666171"}}