Effect of Intensive Rehabilitation on Physical Function and Arterial Function in Community-Dwelling Chronic Stroke Survivors

Background: Atherothrombosis due to arteriosclerosis is a risk factor for recurrence of stroke. Although exercise therapy is essential to prevent progression of arteriosclerosis and to improve endothelial function, little is known about the effect of rehabilitation in chronic stroke survivors. Objective: The purpose of this study was to investigate the effect of intensive rehabilitation on physical and arterial function among community-dwelling stroke survivors. Methods: Forty-four community-dwelling stroke survivors participated in the study. The experimental group (n = 22) received primarily intensive strengthening exercise and the control group (n = 22) received standard physical therapy consisting mainly of stretching and gait training. Both groups underwent the rehabilitation program for 12 weeks. Physical function was evaluated using 10-m gait velocity, the 30-s chair stand test, Timed Up and Go test, and grip strength. Arterial function of the affected and unaffected sides was evaluated using the cardio-ankle vascular index (CAVI) as an index of arterial stiffness and the ankle-brachial pressure index (ABI) as an index of arterial occlusion. Results: After the 12-week rehabilitation period, improvement in physical function did not differ between the 2 groups; whereas with regard to arterial function, a significant improvement in the CAVI for the affected side was observed in the experimental group (P < .001). Also, the ABI for the unaffected side in the experimental group was significantly improved after intervention (P < .001). No significant differences were found for the unaffected-side CAVI and affected-side ABI between the 2 groups. Conclusions: These findings suggested that intensive rehabilitation for stroke patients during the chronic stage preserved physical function and improved arterial function.