Abstract / Summary
Background Excessive inflammation in early phases post-ischemic stroke is associated with poor long-term outcome and increased stroke recurrence. Interventions capable of downregulating persistent states of inflammation could improve recovery and prevent secondary stroke. Cardiovascular exercise (CE) has well-established anti-inflammatory effects but its capacity to attenuate the exaggerated inflammatory response triggered by ischemic stroke is unclear. Methods We investigated the impact of eight weeks of CE on the serum concentration of inflammatory mediators in the early subacute phase post-stroke. Seventy-one patients with first-ever ischemic stroke were randomly assigned to moderate-to-vigorous CE (n=45) or standard care (SC) (n=26). Concentrations of CRP, IL-6, IL-8, IL-10, TNF-α and IL-1β were measured at baseline and after the interventions. Differences between groups were analyzed with linear mixed models adjusted for age and sex. Results Compared with the CE group, the SC group showed significant increases in IL-6 (β=0.585, 95% CI=0.164–1.006, p=0.0073), IL-8 (β=0.160, 95% CI=0.004–0.317, p=0.0447), and TNF-α (β=0.0845, 95% CI=0.0137–0.1553, p=0.0206). The SC group also showed greater increases in CRP (β=0.250, 95% CI=-0.407, 0.906, p=0.4499) and IL-10 (β=0.251, 95% CI=-0.024, 0.527, p=0.0729) but group differences were not significant. IL-1β levels remained stable and differences between groups were not significant (β=-0.008, 95% CI=-0.058, 0.042, p=0.7618). Conclusions When introduced in the early subacute phase of stroke recovery, moderate-to-vigorous CE mitigates increases in inflammation, but the effect differs across mediators. To what extent reducing the inflammatory response in the early stages post-stroke with CE can impact long-term recovery and stroke recurrence needs to be determined.