Background and Purpose Cardiovascular health is often impaired after stroke. Reduced exercise capacity (VO2 peak) and changes in the vascular system in the stroke-affected limb may impact physical performance such as walking. There is little information regarding the role of prescribed moderate-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. Methods Ten subjects were enrolled in the study and 9 completed the intervention. Participants were 61.2 ± 4.7 years old, 66.7 ± 41.5 days post-stroke and had minor motor performance deficits (Fugl-Meyer score, 100.3 ± 29.3). Outcome measures were taken at baseline, post-intervention and one-month follow-up. Brachial artery vasomotor reactivity (flow mediated dilation; FMD) of both arms assessed vascular health and a peak exercise test assessed exercise capacity. The six-minute walk (6-MWT) test was used to assess physical performance. Participants exercised on a recumbent stepper three times per week for eight weeks in a prescribed heart rate (HR) intensity. Results At baseline, we report between-limb differences in brachial artery FMD and low VO2 peak values. After the intervention, significant improvements were reported in FMD in both arms, resting systolic blood pressure (SBP) and the 6MWT. Although we also observed improvements in resting diastolic BP, HR and VO2 peak values, after the exercise intervention, these were not statistically significant Discussion and Conclusion Aerobic exercise in subacute stroke was beneficial for improving cardiovascular health, reducing cardiac risk and improving physical performance (6MWT).

Reduced cardiovascular fitness poststroke 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 VO 2 was significantly lower from baseline to postintervention with a main effect of Study Visit (F 1,8 = 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.

Purpose: Limited research is available for exercise prescription during the subacute stage of stroke recovery. Peak and submaximal cardiorespiratory response during exercise testing in sub-acute stroke has also not been extensively studied. We assessed the hypothesis that an eight-week aerobic exercise intervention at moderate-high intensity would improve cardiorespiratory response during submaximal and peak effort in sub-acute stroke. Methods: Ten individuals (68.6+40.1 days post-stroke) enrolled in the study and 9 participants completed the exercise intervention. The nine participants were 61.2+4.7 years of age with a total Fugl-Meyer score, 102.2+30.4. Peak exercise testing was done at baseline and post-intervention to assess oxygen consumption (VO2), HR and minute ventilation (VE). A seated stepper was the mode of exercise with exercise intensity at 50-59% of HR reserve (first 4 weeks) and then increased to 60-69% of HR reserve for the last 4 weeks. Paired t-tests were used to assess differences at peak effort. Submaximal performance on the exercise test was assessed using an analysis of variance, with Test Minute (minutes 1-6) and Study Visit (baseline, post-exercise) as within subject factors. P-values < 0.05 were considered statistically significant. Results: At peak effort, VO2, HR and VE were higher post-intervention but only VO2 peak was statistically significant. During submaximal effort, we found VO2 and HR to be lower after the exercise intervention. For VO2 there was no interaction (F5,40=0.95, p=0.40) between Study Visit and Test Minute but we report a main effect of Study Visit (F1,8=8.5, p=0.02). There was not a significant interaction for HR between Study Visit and Test Minute (F5,40=0.28, p=0.92). Nor was there a main effect of Study Visit (F1,8=2.7, p=0.14). VE increased similarly across Test Minute and Study Visits. No interaction of Study Visit and Test Minute were evident nor was there a main effect of Study Visit. Conclusion: This preliminary data demonstrates that an 8-week aerobic exercise intervention shows promise for improving peak and submaximal cardiorespiratory response in sub-acute stroke.