BMJ: How effective is the health training of patients with subacute stroke?

The purpose of this study is to explore the safety and efficacy of aerobic exercise in daily life activities in patients with subacute period strokeThe design of multi-center, randomized controlled and end-point double-blind trialwased in seven inpatient rehabilitation centres in Germany (2013-17)adults included in 200 subacute strokes (5-45 days after stroke), the National Institutes of Health stroke scale (NIHSS, range 0-42 points, higher value indicates stroke seriousness) with a median of 8 points (the average score between the two is 5-12 points), in addition to standard care, random allocation (1:1) for aerobic training (n-105) or relaxation (n-95, control group)In addition to standard rehabilitation treatment,participants received aerobics, body weight support, treadmill-based physical training or relaxation training for 25 minutes, 5 times a week for 4 weeksThe researchers and endpoint evaluators covered up the distribution of treatmentthe main result was changes in maximum walking speed (m/s) in the 10-meter walking test and changes in the Barthel index (range 0-100, higher score indicates lower degree of disability) 3 months after the stroke compared to the baselineThe safety results were cardiovascular events that recurd within 3 months of a stroke, including stroke, readmission and deathEfficacy is tested by covariance analysis of each of the key results in the full analysis groupMultiple inductive methodis is used to calculate the missing valuesresults showed that the average change in aerobic physical training did not change the maximum walking speed during 3 months after stroke compared to the relaxation group (the corrected treatment effect was 0.1 m/s (95% confidence interval of 0.0 to 0.2 m/s), P-0.23) or the average change of the Barlthe index score (0 (-5 to 5), and P-0.99)Compared with the relaxation group, the incidence of severe adverse events was higher (the incidence ratio was 0.97 to 3.36) of the confidence interval of 1.81, 95%, the results showed that in patients with moderate to severely affected subacute stroke, aerobic weight-supported treadmill physical training was not better than relaxation training in terms of maximum walking speed and Barthel index score, but had a higher incidence of adverse eventsThese results do not appear to support the use of aerobic weight-supported physical training in patients with subacute stroke to improve daily life activities or maximum walking speed, which should be considered in future guidelines