Aerobic exercise in subacute stroke improves cardiovascular health and physical performance.

BACKGROUND AND PURPOSE: Cardiovascular health is often impaired after stroke. Reduced exercise capacity ((Equation is included in full-text article.)VO(2peak)) and changes in the vascular system in the stroke-affected limb may impact performance of physical activities such as walking. There is little information regarding the role of prescribed moderate- to high-intensity exercise in subacute stroke. The purpose of this study was to examine whether an 8-week aerobic exercise intervention would improve cardiovascular health and physical performance in participants with subacute stroke. METHODS: Ten subjects were enrolled in the study and 9 of them completed the intervention. Participants were aged 61.2 ± 4.7 years old, were 66.7 ± 41.5 days poststroke, and had minor motor performance deficits (Fugl-Meyer score, 100.3 ± 29.3). Outcome measures were taken at baseline, postintervention, and at 1-month follow-up. Brachial artery vasomotor reactivity (flow-mediated dilation [FMD]) of both arms was used to assess vascular health, and a peak exercise test was used to assess exercise capacity. The 6-minute walk test (6MWT) was used to assess physical performance. Participants exercised on a recumbent stepper 3 times per week for 8 weeks at a prescribed heart rate intensity. RESULTS: At baseline, we identified between-limb differences in brachial artery FMD and low (Equation is included in full-text article.)VO(2peak) values. After the intervention, significant improvements were observed in the FMD in both arms, resting systolic blood pressure, and the 6MWT. Although we also observed improvements in the resting diastolic blood pressure, heart rate, and (Equation is included in full-text article.)VO(2peak) values, these changes were not significantly different. DISCUSSION AND CONCLUSION: Aerobic exercise in participants with subacute stroke was beneficial for improving cardiovascular health, reducing cardiac risk, and improving physical performance (6MWT).

Submaximal and peak cardiorespiratory response after moderate-high intensity exercise training in subacute stroke.

PURPOSE: Reduced cardiovascular fitness post-stroke may negatively impact recovery. There is little information regarding exercise testing performance and cardiorespiratory response to an aerobic exercise intervention in subacute stroke. The purpose of this study was to examine cardiorespiratory response in subacute stroke after an 8-week aerobic exercise intervention using a total body recumbent stepper (TBRS). METHODS: Nine individuals with mean age 61.2 (SD 4.7) years and mean 66.7 (SD 41.5) days post-stroke completed the exercise intervention. Participants had a mean Fugl-Meyer score of 100.3 (SD 29.3). Outcome measures were obtained at baseline and postintervention. A peak exercise test using a TBRS assessed oxygen consumption, heart rate, and minute ventilation. Participants completed an 8-week exercise intervention on a recumbent stepper 3 times per week at a prescribed heart rate intensity. RESULTS: Submaximal VO2 was significantly lower from baseline to postintervention with a main effect of Study Visit (F1,8 = 8.5, p = 0.02). Heart rate was not significantly different pre- to postintervention. Minute ventilation exhibited no main effect of Study Visit or Test Minute. CONCLUSION: Moderate-high intensity aerobic exercise in subacute stroke appears to be beneficial for improving cardiovascular outcomes during submaximal performance of an exercise test.

Measures of Cardiovascular Health and Physical Function after an Aerobic Exercise Intervention in a Patient Fifteen Days Post-Stroke.

Study Design: Case Study Background: Changes in cardiorespiratory (CR) fitness post-stroke severely impact an individual's quality of life. The purpose of this case study was to demonstrate whether a moderate to high intensity aerobic exercise program would improve cardiovascular fitness, and physical performance measures in a participant following discharge from acute stroke rehabilitation. The participant is a 58 year-old female who experienced an ischemic stroke 15 days prior to beginning the exercise intervention. Case Description: The participant was provided a supervised 8-week exercise intervention on a Total Body Recumbent Stepper (TBRS). The exercise intervention consisted of three sessions per week; the first 4 weeks the participant exercised at a moderate intensity of 50-59% heart rate reserve (HRR) calculated from the baseline exercise test; the last 4 weeks the intensity was increased to 60-69% HRR. Exercise duration began at 20 minutes with the goal of reaching 30 minutes of continuous exercise at a specified workload. Outcomes: Following 8-weeks of intervention, the participant showed improvement in cardiovascular measures including: resting blood pressure (BP), resting heart rate (HR), VO2 peak, and the maximum distance walked (6-MWT). Conclusion: The use of a moderate to high intensity aerobic exercise intervention may be effective for participants in the sub-acute phase of stroke recovery in order to improve cardiovascular health and physical function.