Safety and Benefits of Moderate to High Intensity Aerobic Exercise During the Subacute Phase of Stroke: A Systematic Review and Meta-analysis.

Severe adverse events were not actively monitored in many studies, so safety estimates are uncertain. Some trials used inactive or sham controls, which may overestimate effects, and fast gait speed was not significant when only time matched active controls were analysed. Many trials excluded people with cardiovascular or pulmonary conditions, older participants, or unstable medical conditions, so the results may not apply to more medically complex patients. Several interventions included strength or resistance training, transcutaneous electrical nerve stimulation, dietary modification or low intensity exercise, so the contribution of aerobic exercise alone cannot be separated. The search did not include Scopus or Web of Science, and some keywords may have missed studies. Follow-up was often short or incomplete, and only 2 studies followed patients for more than 6 months. GRADE ratings for several primary outcomes were low or very low, especially for safety.

The investigators reported no financial or nonfinancial disclosures in relation to this project.

Do not conclude that moderate to high intensity aerobic exercise is proven safe for every subacute stroke patient. Severe cardiac or cerebral events did not differ, but adverse event reporting was inconsistent and the safety evidence was very low quality.