title: Effects of early exercise engagement on vascular risk in patients with transient ischemic attack and nondisabling stroke.
abstract: The objective of this study was to conduct a randomized, parallel-group clinical trial assessed the efficacy of a health-enhancing physical activity program (exercise and education) on vascular risk factors and aerobic fitness in patients who have experienced a transient ischemic attack (TIA) or nondisabling stroke. Sixty patients (69±11 years) completed a baseline (BL) vascular risk stratification and aerobic fitness examination (cycle test) within 2 weeks of symptom onset. Subjects were then randomized to either an 8-week, twice weekly exercise program or to a usual-care control (CON) group. Postintervention (PI) assessments were completed immediately after the intervention and at 3-month follow-up. A series of primary (systolic blood pressure [SBP]) and secondary (vascular risk factors like total cholesterol [TC], high-density lipoproteins, etc.; Framingham risk score; peak oxygen uptake) outcome measures were assessed. Significantly greater reductions in SBP (mean change±SD; -10.4±9.2 mm Hg) and TC (-.53±.90 mmol/L) were observed between BL and PI assessments for the exercise group compared with the CON group (-1.9±15.4 mm Hg and -.08±.59 mmol/L, respectively) (P<.05). These improvements were maintained between the PI and the 3-month follow-up assessment (P>.05). Significant improvements in aerobic fitness were also observed and maintained at the 3-month follow-up assessment after regular exercise participation (P<.05). The early engagement in exercise resulted in significant improvements in vascular risk factors and fitness in those diagnosed with TIA. As these beneficial effects were maintained up to 3 months after completing the exercise program, exercise should be considered a useful additive treatment strategy for newly diagnosed TIA patients. Future research should examine the long-term efficacy of such programs.
authors.affiliation: School of Sport and Exercise, Massey University, Wellington, New Zealand. Electronic address: j.faulkner@massey.ac.nz.
authors.forename: James
authors.initials: J
authors.lastname: Faulkner
authors.forename: Danielle
authors.initials: D
authors.lastname: Lambrick
authors.forename: Brandon
authors.initials: B
authors.lastname: Woolley
authors.forename: Lee
authors.initials: L
authors.lastname: Stoner
authors.forename: Lai-kin
authors.initials: LK
authors.lastname: Wong
authors.forename: Gerard
authors.initials: G
authors.lastname: McGonigal
mesh_terms: D000368:Aged; D004434:Early Ambulation / Q000009:adverse effects*; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D012307:Risk Factors; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology*
keywords: Exercise; TIA; acute interventional treatment; education; prevention