Cardiovascular Fitness and Adaptations to Aerobic Training after Stroke

Abstract

Purpose: This article presents an overview of the current state of knowledge of physiological indicators of cardiovascular fitness after stroke. Clinical tips are presented regarding training protocols appropriate for persons post-stroke. Summary of Key Points: Application of the principles of exercise physiology to stroke rehabilitation has begun to attract the attention of clinicians owing to increased awareness of the profoundly poor fitness levels of persons in the early and chronic post-stroke periods. Contributors to the low exercise capacity range from personal and environmental factors to cardiovascular, neuromuscular, and respiratory dysfunction associated with stroke. Low fitness levels, in turn, negatively influence these factors and, ultimately, health-related quality of life. Nevertheless, there is growing evidence that persons in both the early and chronic post-stroke periods can make cardiovascular adaptations to aerobic training. Conclusions: Given that persons post-stroke respond positively to aerobic exercise if appropriate screening and training protocols are used, implementation of training makes practical sense. However, there is limited information on specific evidence-based guidelines for stroke rehabilitation in clinical and community settings to improve exercise capacity and to protect against further cardiovascular morbidity and mortality.