Supervised cardiorespiratory training decreases post-stroke fatigue and improves cardiorespiratory fitness - a RCT

IntroductionPost-stroke fatigue (PSF) affects nearly half of all stroke survivors and significantly hinders rehabilitation and daily functioning. There is no established treatment. Low cardiorespiratory fitness may contribute to PSF, suggesting aerobic training as a potential intervention. MethodsIn this two-center, randomized, open-label, blinded-endpoint trial, we evaluated a home-based supervised cardiorespiratory interval training program (HS-CITP) in individuals with PSF (Swedish Fatigue Assessment Scale [S-FAS] [&ge;]28) 1-7 months post-stroke. Participants were randomized (1:1) to either HS-CITP or usual care with self-directed activity following early supported discharge. The intervention included three weekly cycling sessions at 70%-80% of maximum heart rate over eight weeks. The primary outcome was self-reported fatigue (S-FAS); the secondary outcome was peak oxygen uptake (VO2peak, mL/kg/min) post-intervention. ResultsForty-five participants were randomized; 43 completed follow-up (HS-CITP: n=22; control: n=21). Adherence to HS-CITP was 92%, with no adverse events. Compared with the control group, HS-CITP significantly reduced fatigue (mean between-group difference -5.35 S-FAS points; 95% CI -9.03 to -3.67; p<.001) and improved cardiorespiratory fitness (+4.48 VO2peak mL/kg/min; 95% CI 3.41-5.54; p<.001). ConclusionSupervised home-based interval training significantly reduced PSF and improved fitness, with high adherence and no safety concerns. These findings support integrating structured aerobic exercise into stroke rehabilitation. Larger, longer-term trials are needed to confirm the durability of this benefit. RegistrationURL: https://www.clinicaltrials.gov; Unique identifier: NCT03458884