Journal Article Ahead of print
PubMed: 40698580 DOI: 10.1080/10749357.2025.2530265
Effect of an aerobic exercise program on cardiac remodeling and functional capacity in patients with stroke: CRONuS trial.
Top Stroke Rehabil
Authors: Josiela Cristina da Silva Rodrigues, Gustavo José Luvizutto, Vitor Mendes Pereira, Rafael Dalle Molle da Costa, Robson Aparecido Prudente, Taís Regina da Silva, Fabiane Valentini Francisqueti Ferron, Caroline Ferreira da Silva Mazeto Pupo da Silveira, Artur Junio Togneri Ferron, Juli Thomaz de Souza, Fernanda Cristina Winckler, Estefânia Aparecida Thomé Franco, Gabriel Pinheiro Modolo, Letícia Cláudia de Oliveira Antunes, Rodrigo Bazan, Luis Cuadrado Martin, Silméia Garcia Zanati Bazan
Affiliations
- Department of Rehabilitation, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil.
- Department of Applied Physical Therapy, Federal University of Triângulo Mineiro (UFTM), Uberaba, Brazil.
- Department of Surgery, Division of Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil.
- Department of Neuroscience and Mental Health, Botucatu Medical School-UNESP, São Paulo State University, Botucatu, Brazil.
Abstract
BACKGROUND
Aerobic exercise training leads to cardiovascular changes and improves cardiovascular performance and functional capacity after a stroke. However, the effect of aerobic exercise on cardiac remodeling in patients with stroke has been poorly explored. This study aimed to investigate the effects of a physical exercise program on morphofunctional echocardiographic variables and the functional capacity of post-stroke patients.
METHODS
This randomized, controlled clinical trial included patients with stroke, categorized into the control group (CG), conventional physiotherapeutic care, and intervention group (IG). The IG underwent a cardiovascular rehabilitation program consisting of warm-up, aerobic exercise, and muscle cooling. Both conventional and test interventions lasted 45 min, three times a week for 16 weeks. The patients underwent transthoracic echocardiography, a 6-minute walk test, neurological and nutritional evaluation, laboratory tests, and QoL assessment initially and at 16 weeks after the intervention.
RESULTS
The IG showed significant reduction in the following morphological echocardiographic variables compared to the CG after intervention: diastolic thicknesses of the posterior wall (p = 0.0001) and interventricular septum (p = 0.004), relative wall thickness (p = 0.001), left ventricular mass (LVM, p < 0.001), LVM index (p < 0.0001), and left atrial diameter (p = 0.003). Regarding systolic and diastolic functions, the IG showed a significant increase in LV ejection fraction (p = 0.001) and tricuspid ring systolic excursion (p = 0.0002), and a reduction in the left atrial volume index (p = 0.001) and E/E' ratio (p = 0.01) compared to the CG. In addition, the IG showed an increase in the distance covered compared to the CG after the intervention (p = 0.04).
CONCLUSIONS
The cardiovascular rehabilitation program improved the cardiac morphological and functional parameters and had a positive impact on the functional capacity of patients with chronic ischemic stroke.
TRIAL REGISTRATION
REBEC, RBR-4wk4b3. Registered on 19 September 2016.
MeSH
Exercise, Stroke, Cardiac Rehabilitation, Rehabilitation, Echocardiography, Walk Test