Safety and feasibility of post-stroke care and exercise after minor ischemic stroke or transient ischemic attack: MotiveS & MoveIT.
BACKGROUND
Despite the beneficial effect of cardiac rehabilitation after myocardial infarction, a rehabilitation program to improve cardiorespiratory fitness and influence secondary prevention has not been implemented for ischemic stroke and transient ischemic attack (TIA).


OBJECTIVE
To investigate the safety and feasibility of a post-stroke care including an exercise program after minor ischemic stroke or TIA.


METHODS
In a randomised controlled trial, 20 patients with a recent minor stroke or TIA without cardiac contraindications were randomly assigned to one of the two interventions; post-stroke care without exercise or post-stroke care with exercise. Patients were evaluated at baseline, 6 and 12 months.


RESULTS
Eighteen patients completed the intervention. In none of the patients cardiopulmonary contraindications for the maximal exercise test and exercise program were found. No cardiovascular events occurred during the maximal exercise tests and exercise program. After one year, significantly more patients in the post-stroke care with exercise group achieved the composite endpoint of optimal medical therapy.


CONCLUSIONS
Post-stroke care including an exercise program is safe and feasible in the acute phase after minor stroke or TIA and might be a way to increase effectiveness of secondary stroke prevention. We are currently conducting a larger trial to validate these results.
Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
H M
HM
Boss
Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
S M
SM
Van Schaik
Department of Physical Therapy, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
I A
IA
Deijle
Department of Cardiology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
E C
EC
de Melker
Department of Respiratory Medicine, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
B T J
BT
van den Berg
Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands.
E J A
EJ
Scherder
Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
W M J
WM
Bosboom
Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
H C
HC
Weinstein
Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands.
R M
RM
Van den Berg-Vos
D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010809:Physical Fitness; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D000071939:Stroke Rehabilitation
Ischemic stroke; TIA; physical exercise; secondary prevention