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. 2025 Jul 23:1-15.
doi: 10.1080/10749357.2025.2530265. Online ahead of print.

Effect of an aerobic exercise program on cardiac remodeling and functional capacity in patients with stroke: CRONuS trial

Josiela Cristina da Silva Rodrigues  1 , Gustavo José Luvizutto  2 , Vitor Mendes Pereira  3 , Rafael Dalle Molle da Costa  1 , Robson Aparecido Prudente  1 , Taís Regina da Silva  1 , Fabiane Valentini Francisqueti Ferron  4 , Caroline Ferreira da Silva Mazeto Pupo da Silveira  4 , Artur Junio Togneri Ferron  4 , Juli Thomaz de Souza  4 , Fernanda Cristina Winckler  4 , Estefânia Aparecida Thomé Franco  4 , Gabriel Pinheiro Modolo  5 , Letícia Cláudia de Oliveira Antunes  1 , Rodrigo Bazan  5 , Luis Cuadrado Martin  4 , Silméia Garcia Zanati Bazan  4
Affiliations

Effect of an aerobic exercise program on cardiac remodeling and functional capacity in patients with stroke: CRONuS trial

Josiela Cristina da Silva Rodrigues et al. Top Stroke Rehabil. .

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Trial registration: REBEC, RBR-4wk4b3. Registered on 19 September 2016.

Keywords: Stroke; aerobic training; cardiovascular rehabilitation; echocardiography; functional capacity.

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