Guideline update highlights aerobic exercise after stroke, TIA

  • MacKay-Lyons M & al.
  • Phys Ther
  • 9 Oct 2019

  • International Clinical Digest
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Takeaway

  • An update of the Aerobic Exercise Recommendations to Optimize Best Practices in Care after Stroke (AEROBICS) aims to facilitate screening for physical activity and prescription of aerobic exercise among patients who have experienced stroke or transient ischemic attack (TIA).

Why this matters

  • Stroke survivors generally have poor cardiovascular fitness, which contributes to heightened risk for recurrence.
  • Guidelines endorse exercise for this population.
  • New evidence has emerged since recommendations first published in 2013.

Key results

  • 20 recommendations total:
    • 7 on screening patients for safe participation.
    • 13 on prescribing aerobic exercise interventions.
  • Recommendation topics range from who should be screened for participation to strategies for encouraging long-term engagement.
  • Each presented with level of evidence and brief rationale.
  • 2 new recommendations address questions pertaining to exercise prescription:
    • How should aerobic exercise be progressed during a training program?
    • What clinical outcome measures should be used to monitor effects of aerobic training?

Study design

  • Canadian and US multidisciplinary consensus panel (physical therapy, stroke, neurology, cardiology, psychology, health policy) reviewed evidence from 2012 to 2018.
  • Main outcome: AEROBICS 2019 recommendations.
  • Funding: Canadian Partnership for Stroke Recovery; Canadian Institutes of Health Research.

Limitations

  • Gaps in the evidence.
  • Uncertainty regarding role of aerobic exercise in this population.