title: Effects of Twice-Weekly Intense Aerobic Exercise in Early Subacute Stroke: A Randomized Controlled Trial.
abstract: To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke.
  
  
  
  Randomized controlled trial.
  
  
  
  Ambulatory care.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.affiliation: 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.
authors.forename: Klas
authors.initials: K
authors.lastname: Sandberg
authors.affiliation: Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Kleist
authors.affiliation: 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.
authors.forename: Lars
authors.initials: L
authors.lastname: Falk
authors.affiliation: 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.
authors.forename: Paul
authors.initials: P
authors.lastname: Enthoven
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D026741:Physical Therapy Modalities; D004856:Postural Balance; D011446:Prospective Studies; D011788:Quality of Life; D000071939:Stroke Rehabilitation / Q000379:methods* / Q000523:psychology
keywords: Exercise; Quality of life; Randomized controlled trial [publication type]; Rehabilitation; Stroke