Cardiorespiratory exercise during rehabilitation is associated with improved functional recovery early post-stroke: A cohort study.

BACKGROUND

Cardiorespiratory exercise (CRE) early post-stroke can improve cardiorespiratory fitness, facilitate participation in rehabilitation, and promote neuroplasticity.

OBJECTIVES

This study aimed to determine if CRE during routine inpatient stroke rehabilitation is associated with improved recovery of motor and cognitive function, functional ambulation, and motor impairment.

METHODS

People (n = 503) admitted to 2 rehabilitation hospitals over 14 months were included in this cohort study. Participants were classified into 3 groups: "Prescribed," where participants completed CRE that was included in their treatment plan; "Incidental," where they completed CRE that was not included in their treatment plan; and "None," where they did not complete any CRE. Analysis of covariance compared Functional Independence Measure (FIM), Functional Ambulation Category (FAC), and Chedoke-McMaster Stroke Assessment (CMSA) scores between groups at discharge, controlling for age, length of stay, comorbidities and scores at baseline. Multiple linear regression determined the relationship between time spent doing CRE during rehabilitation and admission to discharge change in FIM, FAC and CMSA scores, controlling for age, length of stay, comorbidities, and site.

RESULTS

The Prescribed group had higher FIM total and motor sub-scores at discharge than the None (Site A; P < 0.001) or the Incidental group (Site B; P < 0.03). There were significant positive correlations between time spent doing CRE during rehabilitation and change in all outcomes (r > 0.15), except CMSA hand scores.

CONCLUSIONS

Findings support that CRE during routine inpatient rehabilitation early post-stroke is associated with improved functional independence, ambulation and motor recovery. However, given that the observational design limits causal inferences, controlled studies are needed to confirm the benefits of CRE early post-stroke.