Combined Aerobic Exercise and Task Practice Improve Health-Related Quality of Life Poststroke: A Preliminary Analysis.

This is a secondary analysis of two small preliminary randomized trials, not a single adequately powered trial. Only 40 of 48 randomized participants were included in the analysis, and one participant was excluded at the 4-week follow-up. The education control group had only 8 participants, which limits confidence in comparisons with the exercise groups. The main group comparison did not find a difference, so the within-group improvements were secondary comparisons made after the main analysis and may reflect chance or repeated testing. The study excluded people with significant cognitive impairment, major psychiatric disorder, severe depression, or cardiac contraindications, so it does not show results for those groups. The Stroke Impact Scale is self-reported, so improved memory, communication, or percent recovery cannot be taken as measured actual cognition, speech, or recovery. The education group may have had a ceiling effect in cognitive domains. This made it harder to detect improvement.

One author has authored intellectual property associated with the algorithm used in the control of the forced exercise bicycle. The remaining authors declare no conflicts of interest.

Do not conclude that aerobic exercise plus task practice is better than education plus task practice. The main comparison across groups did not find a difference, and the reported improvements were within-group secondary comparisons.