Protein Supplementation for Chronic Stroke Treatment

This is a multicenter randomized control trial. Participants will be recruited from 4 teaching hospitals in Taipei. Participants are randomly assigned to 2 groups:

• protein supplementation + exercise (PRO group);
• carbohydrate supplementation + exercise (CHO group);

The 1-hour exercise intervention includes aerobic cycling exercise followed by progressive resisted exercise with TheraBand. PRO group receives PS immediately before and after the exercise while the CHO group receive sham product (the same calories with no protein). The Interventions are arranged 3 sessions a week for 10 weeks. The outcome measurements are performed at 0-week, 10-week, and 20-week.

Inclusion criteria

• Chronic stroke>6months
• Age : 20-75 y
• Able to walk independently over 10 mins (with or without orthosis)
• Able to use stationary bike

Exclusion criteria

• Physiological condition not stable, cognitive dysfunction, not able to coordinate with examine or treatments.
• Not able to exercise due to severe cardiopulmonary dysfunction
• Malnutrition (MNA<11)
• Severe obesity (BMI>35)
• Renal insufficiency
• Unable to tolerate our cardiopulmonary exercise test (CPET) (eg, too short stature to fit the machine, leg spasticity is too strong to peddle the cycling, unable to maintain 50 rpm at the beginning of CPET, indications for early termination of CPET based on the American College of Sport Medicine suggestions)