"Are Cardiac Rehabilitation Programs Effective in Improving Aerobic Capacity for People with Transient Ischemic Attack and Stroke? A Rapid Review and Meta-analysis".

Abstract

Evaluate the effectiveness of exercise-based cardiac rehabilitation in improving aerobic capacity for people with stroke or TIA. This is a rapid review with meta-analysis. Four databases were searched from February 2015 - March 2025. Nine studies (n=490 participants) of low-moderate quality were included (two randomised controlled trials, two quasi-experimental trials, five pre-post studies), three of which were pooled for meta-analysis. Findings suggest cardiac rehabilitation improves aerobic capacity (28 m, 95% CI 16 m to 39 m, P=<0.00001) for people with TIA or stroke, with promising improvements also found for systolic blood pressure (95% CI -18 mm Hg to -5.3 mm Hg, P=0.0003), self-reported diet (95% CI 2.4 to 4.7, P=<0.00001) and self-reported physical activity (95% CI 1533 METmin/week to 5156 METmin/week, P=0.0003). No significant relationships were identified between program FITT (exercise frequency, intensity, type, time) principles and aerobic capacity outcomes. Cardiac rehabilitation may be effective in improving aerobic capacity post-TIA or stroke, however current evidence is limited and of low certainty. Further high-quality research on program effectiveness, and the influence of FITT principles, is needed to support evidence-based decisions making by clinicians, researchers and policy-makers.