Effects of Twice-Weekly Intense Aerobic Exercise in Early Subacute Stroke: A Randomized Controlled Trial

Publication date: Available online 20 February 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Klas Sandberg, Marie Kleist, Lars Falk, Paul Enthoven
ObjectiveTo examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke.DesignRandomized controlled trial.SettingAmbulatory care.ParticipantsFifty-six patients (28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset.InterventionsSixty minutes of group aerobic exercise, including 2 × 8 minutes of exercise with intensity up to exertion level 14–15/20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). Controls (n=27) received no organized rehabilitation or scheduled physical exercise.Main Outcome MeasuresPrimary outcome measures: Aerobic capacity: Standard ergometer exercise stress test (peak work rate (WR)). Walking distance: 6-Minute Walk Test (6MWT). Secondary outcomes measures: Maximum Walking Speed 10 meters (MWS10m). Balance: Timed Up and Go (TUG), Single Leg Stance (SLS). Health-related quality of life: Euroqol-5D (EQ-5D). Participation and recovery after stroke: Stroke Impact Scale 2.0 (SIS) domains 8 and 9. Participants were evaluated pre-intervention and post-intervention; patient-reported measures were also evaluated at a 6-month follow-up.ResultsThe following improved significantly more in the intervention group (pre- to post-intervention): peak WR (group x time interaction P=.006), 6MWT (P=.011), MWS10m (P<.001), TUG (P<.001), SLS right and left (eyes open) (P<.001 and P=.022 respectively), and SLS right (eyes closed) (P=.019). Aerobic exercise was associated with improved EQ-5D VAS; P=.008) and perceived recovery (SIS domain 9; P=.002). These patient-reported improvements persisted at the 6-month follow-up.ConclusionsIntensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery.



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