Exercise & Fitness

Cardiorespiratory Training After Stroke Boosts Fitness But Falls Short of Clinical Thresholds

This Cochrane systematic review pooled data from 53 randomized controlled trials (2,672 participants) to evaluate cardiorespiratory training after stroke. The good news: aerobic exercise is safe — it does not increase mortality or secondary cardiovascular events. It also produces modest improvements in VO2max, walking speed, disability scores, and balance. The concerning nuance is that most of these gains fall below established minimal clinically important difference thresholds, meaning their real-world impact on daily function is uncertain. Evidence quality is limited by small study sizes, risk of bias, and imbalanced exercise exposure between groups. Longer programs (12+ weeks) showed greater fitness benefits. Researchers conclude that aerobic exercise post-stroke is a safe and worthwhile addition to rehabilitation but call for larger, better-designed trials to clarify optimal exercise prescriptions and long-term outcomes.