Effects of early exercise engagement on vascular risk in patients with transient Ischemic attack and nondisabling stroke

Faulkner, James, Lambrick, Danielle, Woolley, Brandon, Stoner, Lee, Wong, Lai-kin and McGonigal, Gerard (2013) Effects of early exercise engagement on vascular risk in patients with transient Ischemic attack and nondisabling stroke. Journal of Stroke and Cerebrovascular Diseases, 22 (8), e388-e396. (doi:10.1016/j.jstrokecerebrovasdis.2013.04.014).

Abstract

The objective of this study was to conduct a randomized, parallel-group clinical trial assessed the efficacy of a health-enhancing physical activity program (exercise and education) on vascular risk factors and aerobic fitness in patients who have experienced a transient ischemic attack (TIA) or nondisabling stroke. Sixty patients (69 ± 11 years) completed a baseline (BL) vascular risk stratification and aerobic fitness examination (cycle test) within 2 weeks of symptom onset. Subjects were then randomized to either an 8-week, twice weekly exercise program or to a usual-care control (CON) group. Postintervention (PI) assessments were completed immediately after the intervention and at 3-month follow-up. A series of primary (systolic blood pressure [SBP]) and secondary (vascular risk factors like total cholesterol [TC], high-density lipoproteins, etc.; Framingham risk score; peak oxygen uptake) outcome measures were assessed. Significantly greater reductions in SBP (mean change ± SD; ?10.4 ± 9.2 mm Hg) and TC (?.53 ± .90 mmol/L) were observed between BL and PI assessments for the exercise group compared with the CON group (?1.9 ± 15.4 mm Hg and ?.08 ± .59 mmol/L, respectively) (P < .05). These improvements were maintained between the PI and the 3-month follow-up assessment (P > .05). Significant improvements in aerobic fitness were also observed and maintained at the 3-month follow-up assessment after regular exercise participation (P < .05). The early engagement in exercise resulted in significant improvements in vascular risk factors and fitness in those diagnosed with TIA. As these beneficial effects were maintained up to 3 months after completing the exercise program, exercise should be considered a useful additive treatment strategy for newly diagnosed TIA patients. Future research should examine the long-term efficacy of such programs.

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Contributors

Author: Danielle Lambrick

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