Cardiovascular exercise mitigates inflammation in the early subacute phase of stroke recovery: a secondary analysis of a randomized controlled trial
- 1McGill University
Abstract
BackgroundExcessive 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.
MethodsWe 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- and IL-1{beta} were measured at baseline and after the interventions. Differences between groups were analyzed with linear mixed models adjusted for age and sex.
ResultsCompared with the CE group, the SC group showed significant increases in IL-6 ({beta}=0.585, 95% CI=0.164-1.006, p=0.0073), IL-8 ({beta}=0.160, 95% CI=0.004-0.317, p=0.0447), and TNF- ({beta}=0.0845, 95% CI=0.0137-0.1553, p=0.0206). The SC group also showed greater increases in CRP ({beta}=0.250, 95% CI=-0.407, 0.906, p=0.4499) and IL-10 ({beta}=0.251, 95% CI=-0.024, 0.527, p=0.0729) but group differences were not significant. IL-1{beta} levels remained stable and differences between groups were not significant ({beta}=-0.008, 95% CI=-0.058, 0.042, p=0.7618).
ConclusionsWhen 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.
Versions
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BibTeX
@misc{heras2026cardiovascular,
title = {{Cardiovascular exercise mitigates inflammation in the early subacute phase of stroke recovery: a secondary analysis of a randomized controlled trial}},
author = {B. de las Heras and L. Rodrigues and K. Moncion and A. Van Roy and M. Lotlikar and F. michalakis and K. Sikorska and A. Sutoski and A. Bon and N. Arbour and M. Bayley and J. J. Eng and M. Roig},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.28.26364152},
url = {https://www.medrxiv.org/content/10.64898/2026.09.28.26364152v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Cardiovascular exercise mitigates inflammation in the early subacute phase of stroke recovery: a secondary analysis of a randomized controlled trial
AU - B. de las Heras
AU - L. Rodrigues
AU - K. Moncion
AU - A. Van Roy
AU - M. Lotlikar
AU - F. michalakis
AU - K. Sikorska
AU - A. Sutoski
AU - A. Bon
AU - N. Arbour
AU - M. Bayley
AU - J. J. Eng
AU - M. Roig
PY - 2026
DA - 2026/09/28
PB - medRxiv
DO - 10.64898/2026.09.28.26364152
UR - https://www.medrxiv.org/content/10.64898/2026.09.28.26364152v1
AB - BackgroundExcessive 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. MethodsWe 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- and IL-1{beta} were measured at baseline and after the interventions. Differences between groups were analyzed with linear mixed models adjusted for age and sex. ResultsCompared with the CE group, the SC group showed significant increases in IL-6 ({beta}=0.585, 95% CI=0.164-1.006, p=0.0073), IL-8 ({beta}=0.160, 95% CI=0.004-0.317, p=0.0447), and TNF- ({beta}=0.0845, 95% CI=0.0137-0.1553, p=0.0206). The SC group also showed greater increases in CRP ({beta}=0.250, 95% CI=-0.407, 0.906, p=0.4499) and IL-10 ({beta}=0.251, 95% CI=-0.024, 0.527, p=0.0729) but group differences were not significant. IL-1{beta} levels remained stable and differences between groups were not significant ({beta}=-0.008, 95% CI=-0.058, 0.042, p=0.7618). ConclusionsWhen 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.
ER -