Hemodynamic responses to In-Bed Cycle Exercise in the acute phase after moderate to severe stroke: A randomized controlled trial

Abstract

Hemodynamic responses to exercise in the acute phase after moderate to severe stroke have remained poorly investigated. The aim of this randomized controlled study, in which 52 (32 women) patients with moderate to severe stroke were randomized to three weeks of 20 minutes in-bed cycle exercise 5 days per week or to usual care, was to explore the systolic blood pressure (SBP) response to exercise and to evaluate the impact of the intervention on the resting and post-test systolic and diastolic blood pressures and heart rate, and on the systolic blood pressure response to exercise. We found that resting SBP decreased from baseline to post-intervention in both the intervention group (147.7 ± 18.1 mmHg to 125.3 ± 17.1 mmHg, P < .001) and in the control group (147.8 ± 23.7 mmHg to 131.4 ± 14.8 mmHg, P < .001) without a significant difference between the groups (interaction P = .308). However, there was a significant difference (interaction P = .010) regarding how Δ SBP (change in SBP from pre-test to post-test) changed from baseline to post-intervention. In the intervention group, Δ SBP increased from -1.0 ± 15.0 mmHg to 8.5 ± 9.4 mmHg, P = .009, whereas in the control group, Δ SBP decreased from 7.1 + 10.9 mmHg to 4.5 + 11.8 mmHg, P = .395. We conclude that patients randomized to in-bed cycle exercise seemed to normalize their blood pressure response to exercise to a larger extent than patients in the control group.

Trial registration: ClinicalTrials.gov NCT04241952.

Keywords: exercise; hypertension; rehabilitation; stroke.

Conflict of interest statement

No commercial party having a direct financial interest in the result of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.

© 2021 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.

Figures

FIGURE 1

Changes in Resting (pre‐) and post‐test systolic blood pressure (SBP) and ΔSBP between baseline and post‐intervention by randomization groups. Upper figure: Resting SBP changes from baseline to post‐intervention. Center figure: Post exercise SBP changes from baseline to post‐intervention. Lower figure: ΔSBP changes from baseline to post‐intervention Δ = Post‐test SBP – Resting SBP.