Klas Sandberg1, Marie Kleist2, Lars Falk3, Paul Enthoven4. 1. Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden; Department of Internal Medicine, Vrinnevi Hospital, Norrköping, Sweden. Electronic address: klas.sandberg@regionostergotland.se. 2. Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden. 3. Research and Development Unit of Local Health Care and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Dermatology and Venereology Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 4. Research and Development Unit of Local Health Care and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Abstract
OBJECTIVE: To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of lifeafter subacute stroke. DESIGN: Randomized controlled trial. SETTING: Ambulatory care. PARTICIPANTS: Patients (N=56; 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. INTERVENTIONS: Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise. MAIN OUTCOME MEASURES: Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up. RESULTS: The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001), TUG test (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 scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up. CONCLUSIONS:Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery.
RCT Entities:
OBJECTIVE: To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke. DESIGN: Randomized controlled trial. SETTING: Ambulatory care. PARTICIPANTS: Patients (N=56; 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. INTERVENTIONS: Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise. MAIN OUTCOME MEASURES: Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up. RESULTS: The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001), TUG test (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 scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up. CONCLUSIONS: Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery.
Authors: David H Saunders; Mark Sanderson; Sara Hayes; Maeve Kilrane; Carolyn A Greig; Miriam Brazzelli; Gillian E Mead Journal: Cochrane Database Syst Rev Date: 2016-03-24
Authors: Magnus O Wijkman; Klas Sandberg; Marie Kleist; Lars Falk; Paul Enthoven Journal: J Clin Hypertens (Greenwich) Date: 2018-01-16 Impact factor: 3.738