Effect of an aerobic exercise program on cardiac remodeling and functional capacity in patients with stroke: CRONuS trial.
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.
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.
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).
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.
REBEC, RBR-4wk4b3. Registered on 19 September 2016.
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.
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).
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.
REBEC, RBR-4wk4b3. Registered on 19 September 2016.
Authors
da Silva Rodrigues da Silva Rodrigues, Luvizutto Luvizutto, Mendes Pereira Mendes Pereira, Dalle Molle da Costa Dalle Molle da Costa, Prudente Prudente, da Silva da Silva, Francisqueti Ferron Francisqueti Ferron, Ferreira da Silva Mazeto Pupo da Silveira Ferreira da Silva Mazeto Pupo da Silveira, Togneri Ferron Togneri Ferron, Thomaz de Souza Thomaz de Souza, Winckler Winckler, Thomé Franco Thomé Franco, Pinheiro Modolo Pinheiro Modolo, Cláudia de Oliveira Antunes Cláudia de Oliveira Antunes, Bazan Bazan, Cuadrado Martin Cuadrado Martin, Zanati Bazan Zanati Bazan
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