Background and Purpose: Each year between 40,000 and 50,000 strokes occur in Canada and currently there are approximately 300,000 Canadians living with the effects of stroke. There has been little research regarding the benefits of aerobic exercise training on cardiovascular risk factors and changes in functional capacity in this population. Studies have reported peak functional capacity in the stroke population well below that of the general population (4 METs). Improvements in functional capacity following exercise training have been reported between 8% and 22%. The purpose of this study is to investigate the changes in functional capacity following a 12-week supervised exercise program, for men and women with nondisabling stroke or transient ischemic attack [cerebrovascular disease (CVD)] and to compare these changes to subjects with coronary artery disease (CAD), peripheral vascular disease (PVD) and those with risk factors for cardiovascular disease (primary prevention).

Methods: Data were analyzed from 93 subjects (53 males and 40 females, mean age = 61 years, range = 32-80 years). Of the males, 39 had CAD, 4 had CVD, and 10 were primary prevention. Of the females, 18 had CAD, 5 had CVD, 2 had PVD, and 15 were primary prevention. All subjects underwent maximal symptom-limited treadmill stress testing at program start and finish. Maximal functional capacity was reported in metabolic equivalents (METs). Subjects underwent 12 weeks of once or twice a week supervised exercise sessions, including a 10- to 15-minute warm-up and cool-down and a 30-minute aerobic component (a combination of treadmill, stationary bike, and aerobic stepping). Exercise intensity was gradually progressed and subjects were trained between 50% and 85% of their heart rate reserve. All subjects were provided with a home program and encouraged to exercise independently 3 to 5 days per week.

Results: Subjects with CVD showed greatest improvements in functional capacity (+2.10 METs = 26.2% increase for women; +1.68 METS = 16.3% increase for men). Those with CAD had the next highest improvements in functional capacity (+1.14 METs = 14.6% increase for women; +1.34 METs = 13.3% for men). The primary prevention group showed the lowest gains in functional capacity (+1.13 METs = 14.8% increase for women; +0.70 METs = 7.6% increase for men). There were no data available for functional capacity and men with PVD; however, the small number of women with PVD showed large improvements (+2.40 METs = 24.2% increase). Women who exercised twice/week showed greater improvements than the once/week group and the men showed a similar trend except for those with CVD and CAD who had greater improvements with once/week exercise.

Conclusions: Subjects with CVD had greater improvements in functional capacity than all other groups, with women showing greater gains than men. Substantial gains in functional capacity can be made when subjects participate in a supervised exercise program plus home exercise. The quantity and intensity of exercise required to produce these changes will become more apparent as further data are compiled.